title: Graft failure and intraocular pressure control after keratoplasty in iridocorneal endothelial syndrome.
abstract: OBJECTIVE
  To describe and compare graft survival and intraocular pressure (IOP) control after penetrating keratoplasty (PK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with iridocorneal endothelial (ICE) syndrome.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Multicenter study conducted at the Singapore National Eye Centre (SNEC) and Price Vision Group. Twenty-nine consecutive eyes with ICE syndrome that underwent keratoplasty between 1991 and 2011 were identified from the SNEC transplant database and Price Vision Group patient database and the following data extracted: demographics, graft failure, IOP indices, and glaucoma treatment pre- and postkeratoplasty. The main outcome measures were graft failure and need for additional IOP-lowering treatment after keratoplasty.
  
  
  RESULTS
  The mean follow-up duration was 7.0 ± 4.9 years in the PK group (n = 17) and 4.0 ± 2.6 years in the DSAEK group (n = 12). After a mean of 4.1 ± 3.1 years, 37.9% of grafts (11/29) failed: 7 PK compared to 4 DSAEK (P = .72). The graft failure rate was 50% in eyes with prekeratoplasty glaucoma surgery vs 31.6% in those without (P = .43). Additional glaucoma treatment was required in 37.9% of eyes (11/29): 41.2% of PK eyes and 50% of DSAEK eyes (P = .28) Eyes that had undergone glaucoma surgery before keratoplasty were less likely to require escalation of IOP-lowering therapy postkeratoplasty (9.1% vs 50%, P = .03).
  
  
  CONCLUSIONS
  One-third of grafts failed after keratoplasty for ICE syndrome at a mean duration of 4 years and additional IOP-lowering treatment was required in 37.9%. Both PK and DSAEK had similar outcomes with regard to graft failure and IOP control.
authors.affiliation: Singapore National Eye Centre, Singapore; Singapore National Eye Research Institute, Singapore.
authors.forename: Desmond Tung-Lien
authors.initials: DT
authors.lastname: Quek
authors.affiliation: Singapore National Eye Research Institute, Singapore.
authors.forename: Chee Wai
authors.initials: CW
authors.lastname: Wong
authors.affiliation: Singapore National Eye Centre, Singapore; Singapore National Eye Research Institute, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore.
authors.forename: Tina T
authors.initials: TT
authors.lastname: Wong
authors.affiliation: Singapore National Eye Research Institute, Singapore; Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.
authors.forename: Sang Beom
authors.initials: SB
authors.lastname: Han
authors.affiliation: Singapore National Eye Research Institute, Singapore.
authors.forename: Hla Myint
authors.initials: HM
authors.lastname: Htoon
authors.affiliation: Singapore National Eye Centre, Singapore; Singapore National Eye Research Institute, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University Hospital Health System, Singapore.
authors.forename: Ching Lin
authors.initials: CL
authors.lastname: Ho
authors.affiliation: Singapore National Eye Centre, Singapore; Singapore National Eye Research Institute, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University Hospital Health System, Singapore.
authors.forename: Donald T
authors.initials: DT
authors.lastname: Tan
authors.affiliation: Price Vision Group, Indianapolis, Indiana.
authors.forename: Francis W
authors.initials: FW
authors.lastname: Price
authors.affiliation: Cornea Research Foundation of America, Indianapolis, Indiana.
authors.forename: Marianne O
authors.initials: MO
authors.lastname: Price
authors.affiliation: Singapore National Eye Centre, Singapore; Singapore National Eye Research Institute, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University Hospital Health System, Singapore. Electronic address: jodmehta@gmail.com.
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000368:Aged; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006084:Graft Rejection / Q000503:physiopathology*; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D057129:Iridocorneal Endothelial Syndrome / Q000503:physiopathology / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology