PMID- 19643499
OWN - NLM
STAT- MEDLINE
DCOM- 20090924
LR  - 20220408
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 116
IP  - 9
DP  - 2009 Sep
TI  - Visual acuity and intraocular pressure after Descemet's stripping endothelial 
      keratoplasty in eyes with and without preexisting glaucoma.
PG  - 1644-50
LID - 10.1016/j.ophtha.2009.05.034 [doi]
AB  - PURPOSE: (1) To characterize the pattern of intraocular pressure (IOP) changes 
      after Descemet's stripping endothelial keratoplasty (DSEK) in patients without 
      preexisting glaucoma and in those with preexisting glaucoma, with and without 
      prior glaucoma surgery. (2) To compare vision and IOP outcomes among the 3 
      groups. DESIGN: A retrospective chart review. PARTICIPANTS: A total of 805 DSEK 
      cases performed in 641 patients by a single surgeon from December 2003 to August 
      2007 were available in the database. Only the first-treated eye of each patient 
      with at least 1-year follow-up was included. Four hundred cases qualified: 315 
      eyes had no glaucoma (C); 64 eyes had glaucoma with no previous glaucoma surgery 
      (G); and 21 eyes had prior glaucoma surgery (GS). Eyes with preexisting retinal 
      problems were included in the analysis. METHODS: Data analysis included 
      calculation of incidence of postoperative IOP elevation. The study criteria for 
      postoperative IOP elevation were IOP > or =24 mmHg or IOP increase > or =10 mmHg 
      from baseline. Kruskal-Wallis test was used to compare visual acuity (VA) and IOP 
      among the 3 groups preoperatively and at 1-, 3-, 6-, and 12-month postoperative 
      visits. MAIN OUTCOME MEASURES: Visual acuity (Snellen) and IOP (millimeters of 
      mercury). RESULTS: The incidence of postoperative IOP elevation by the study 
      criteria was 35%, 45%, and 43% for groups C, G, and GS, respectively. Elevated 
      IOP was medically managed by initiating or increasing glaucoma medications or 
      reducing steroids in 27%, 44%, and 38% of the patients in groups C, G, and GS, 
      respectively. A subsequent glaucoma procedure was performed in 0.3%, 5%, and 19% 
      of patients in groups C, G, and GS, respectively. Only the control group had 
      statistically significant IOP elevation at 12 months (median increase of 2 mmHg) 
      when compared with baseline (P<0.0001). All 3 groups had statistically 
      significant improvement in vision at 12 months when compared with baseline 
      (12-month median VA = 20/40 for C and G; and 20/50 for GS, P<0.0001). 
      CONCLUSIONS: All groups had a substantial incidence of IOP elevation after DSEK. 
      Close monitoring of IOP is warranted. In this cohort, preexisting glaucoma did 
      not seem to have a negative effect on VA after DSEK. FINANCIAL DISCLOSURE(S): 
      Proprietary or commercial disclosure may be found after the references.
FAU - Vajaranant, Thasarat S
AU  - Vajaranant TS
AD  - Department of Ophthalmology and Visual Sciences, University of Illinois at 
      Chicago, 1855 W. Taylor Street, Chicago, IL 60612, USA. thasarat@uic.edu.
FAU - Price, Marianne O
AU  - Price MO
FAU - Price, Francis W
AU  - Price FW
FAU - Gao, Weihua
AU  - Gao W
FAU - Wilensky, Jacob T
AU  - Wilensky JT
FAU - Edward, Deepak P
AU  - Edward DP
LA  - eng
GR  - 1P20 RR023411-01/RR/NCRR NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20090729
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
RN  - 0 (Antihypertensive Agents)
SB  - IM
CIN - Ophthalmology. 2010 Jul;117(7):1460-1; author reply 1461-2. PMID: 20609998
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antihypertensive Agents/therapeutic use
MH  - Corneal Diseases/surgery
MH  - *Corneal Transplantation
MH  - Descemet Membrane/*surgery
MH  - Endothelium, Corneal/*transplantation
MH  - Female
MH  - Filtering Surgery
MH  - Follow-Up Studies
MH  - Glaucoma/*physiopathology/therapy
MH  - Humans
MH  - Intraocular Pressure/*physiology
MH  - Male
MH  - Middle Aged
MH  - Ocular Hypertension/physiopathology/therapy
MH  - Postoperative Complications
MH  - Retrospective Studies
MH  - Tonometry, Ocular
MH  - Visual Acuity/*physiology
MH  - Young Adult
EDAT- 2009/08/01 09:00
MHDA- 2009/09/25 06:00
CRDT- 2009/08/01 09:00
PHST- 2008/12/10 00:00 [received]
PHST- 2009/05/17 00:00 [revised]
PHST- 2009/05/26 00:00 [accepted]
PHST- 2009/08/01 09:00 [entrez]
PHST- 2009/08/01 09:00 [pubmed]
PHST- 2009/09/25 06:00 [medline]
AID - S0161-6420(09)00569-7 [pii]
AID - 10.1016/j.ophtha.2009.05.034 [doi]
PST - ppublish
SO  - Ophthalmology. 2009 Sep;116(9):1644-50. doi: 10.1016/j.ophtha.2009.05.034. Epub 
      2009 Jul 29.