title: Nonpenetrating deep sclerectomy for glaucoma after descemet stripping automated endothelial keratoplasty: three consecutive case reports.
abstract: The purpose of this study was to evaluate the efficacy and safety of nonpenetrating deep sclerectomy (NPDS) in 3 consecutive eyes with preexisting and uncontrolled glaucoma after Descemet stripping with automated endothelial keratoplasty (DSAEK).NPDS with intrascleral implant and topical adjunctive intraoperative mitomycin C (0.2 mg/mL 1 minute) was performed.Intraocular pressure (IOP) and number of glaucoma medication were registered before and after NPDS with at least 1-year follow-up. Intraoperative and postoperative complications were also registered.Before NPDS, IOP was 18 mm Hg in 1 patient and 32 mm Hg in the other 2 patients. Four antiglaucoma drugs were used in 2 cases and 3 in the other one. At 1 year after NPDS, all the patients had an IOP ≤18 mm Hg. Two patients required postoperative antiglaucoma medications (1 drug in 1 case and 2 drugs in the other one). Neodymium-doped yttrium aluminum garnet laser goniopuncture was needed in 2 patients and it had to be repeated in 1 of them. No complications related to NPDS were observed. A corneal graft rejection was observed 5 months after NPDS in 1 case that resolved without sequelae with intensive corticosteroid eye-drop therapy.NPDS could be a safe and successful alternative to conventional filtration surgery after DSAEK in eyes with uncontrolled glaucoma. Larger series and a longer follow-up would be necessary to set the actual role of surgery in DSAEK patients.
authors: From the Ophthalmology Department, Ramon y Cajal University Hospital, IRYCIS, University of Alcala, 28034 Madrid, Spain.
authors: Francisco J
authors: FJ
authors: Muñoz-Negrete
authors: Francisco
authors: F
authors: Arnalich-Montiel
authors: Alfonso
authors: A
authors: Casado
authors: Gema
authors: G
authors: Rebolleda
mesh_terms: D000287:Administration, Topical; D000368:Aged; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D012599:Sclerostomy / Q000379:methods*
chemical_list: D016685:Mitomycin