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Corneal Graft Survival and Intraocular Pressure Control in Coexisting Penetrating Keratoplasty and Pars Plana Ahmed Glaucoma Valves

Lieberman, Rachel A. MD; Maris, Peter J. G. Jr MD; Monroe, Howard M. PhD; Al-Aswad, Lama A. MD; Bansal, Rajendra MD; Lopez, Robert MD; Florakis, George J. MD

doi: 10.1097/ICO.0b013e31823cbd29
Clinical Science

Purpose To evaluate corneal graft survival and intraocular pressure (IOP) control after penetrating keratoplasty (PK) and pars plana Ahmed Glaucoma Valve (AGV) implantation among patients with coexisting glaucoma and corneal disease.

Methods Retrospective chart review at an institution of 25 eyes (24 patients) that received PK and pars plana AGV.

Results The mean postoperative follow-up was 23 months (range, 2–106 months). Survival of the grafts was 89% (16 of 18 eyes) at 1 year and 63% (5 of 8) at 2 years. IOP control was 78% (15 of 19) at 1 year and 44% (4 of 9) at 2 years. By Kaplan–Meier analysis, the 50% probability of sustained graft clarity occurred at 28 months and that of sustained IOP control at 24 months. By last follow-up, best-corrected visual acuity had improved by at least 1 line in 52% (13 of 25) of eyes compared with preoperative values. Preoperative factors, including peripheral anterior synechiae, were not found to be associated with graft survival, IOP control, or visual acuity at 1 year.

Conclusion Pars plana AGV can successfully control IOP in PK patients in the short and intermediate terms, but graft clarity and IOP control diminish over time. Graft decompensation, when it did occur, likely reflects the associated ocular morbidity and clinical complexity of this circumscribed cohort of eyes.

*Edward S. Harkness Institute, Columbia University Medical Center, New York, NY

Department of Mathematics, Our Lady of the Lake University, San Antonio, TX.

Reprints: Peter J. G. Maris, Jr, Edward S. Harkness Eye Institute Mailbox 34, Columbia University Medical Center, 635 West 165th St, New York, NY 10032 (e-mail: lieberman.ophtho@gmail.com).

The authors state that they have no conflicts of interest or financial disclosures to declare.

Received February 8, 2011

Accepted June 3, 2012

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.