title: Descemet Stripping Endothelial Keratoplasty in Eyes With Previous Glaucoma Surgery.
abstract: OBJECTIVE
  To evaluate visual outcomes and complications after Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with previous glaucoma surgery.
  
  
  METHODS
  A retrospective chart review was conducted of 129 procedures in 102 eyes of 96 patients who underwent DSAEK and previous glaucoma surgery at New York Eye and Ear Infirmary of Mt Sinai. The mean length of follow-up was 29.1 ± 25.5 months. Patients with postoperative follow-up duration of less than 3 months were excluded from analysis. Intraoperative and postoperative complications, postoperative course, and visual outcomes were analyzed.
  
  
  RESULTS
  Graft dislocation occurred in 46 eyes (35.7%) and 38 eyes required repeat injection of air in the anterior chamber. Primary graft failure occurred in 3 eyes (2.3%), early graft failure in 20 eyes (15.5%), and secondary graft failure developed in 29 eyes (22.5%). There was a statistically significant increase in secondary graft failure in patients with previous aqueous shunt implantation compared with eyes with previous trabeculectomy (P = 0.03). Escalation of glaucoma therapy was needed medically in 25 eyes (24.5%), and 8 eyes (7.8%) required additional surgical intervention.
  
  
  CONCLUSIONS
  There is a significant incidence of graft dislocation and graft failure after DSAEK in eyes with previous glaucoma surgery. In particular, aqueous shunt surgery compared with trabeculectomy may decrease long-term graft survival, and close follow-up is warranted.
authors.affiliation: *Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, NY;†Department of Ophthalmology, New York Eye and Ear Infirmary of Mt. Sinai, New York, NY; and‡Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY.
authors.forename: Joann J
authors.initials: JJ
authors.lastname: Kang
authors.forename: David C
authors.initials: DC
authors.lastname: Ritterband
authors.forename: Kevin
authors.initials: K
authors.lastname: Lai
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Liebmann
authors.forename: John A
authors.initials: JA
authors.lastname: Seedor
mesh_terms: D000368:Aged; D003316:Corneal Diseases / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D014130:Trabeculectomy; D014792:Visual Acuity / Q000502:physiology