Glaucoma drainage device implantation and cyclophotocoagulation in the management of refractory glaucoma after Descemet-stripping automated endothelial keratoplasty  

作　　者：Min-Shu Wang Xue-Chuan Dong Mi-Yun Zheng Xiang Fan Ge-Ge Xiao Jing Hong Ling-Ling Wu 

机构地区：[1]Department of Ophthalmology,Peking University Third Hospital,Beijing 100191,China [2]Key Laboratory of Restoration of Damaged Ocular Nerve,Beijing 100191,China [3]NIMO Ophthalmology Research Institute,Beijing 100176,China [4]Department of Ophthalmology,the First Hospital of Putian,Teaching Hospital,Fujian Medical University,Putian 351100,Fujian Province,China

出　　处：《International Journal of Ophthalmology(English edition)》2024年第2期257-264,共8页国际眼科杂志（英文版）

摘　　要：AIM:To compare the surgical outcomes of glaucoma drainage device implantation(GDI)and trans-scleral neodymium:YAG cyclophotocoagulation(CPC)in the management of refractory glaucoma after Descemetstripping automated endothelial keratoplasty(DSAEK).METHODS:This retrospective study on observational case series enrolled 29 patients who underwent DSAEK and posterior anti-glaucoma surgery(15 with GDI and 14 with CPC).The main outcome measures were intraocular pressure(IOP),glaucoma surgery success rate(defined as IOP of 6–21 mm Hg without additional anti-glaucoma operation),number of glaucoma medications,endothelial graft status,and best-corrected visual acuity(BCVA).RESULTS:The mean follow-up time was 34.1 and 21.0mo for DSAEK or glaucoma surgeries,both for the GDI and CPC groups.Both groups showed significant IOP reduction after glaucoma surgery.The GDI group presented a significantly higher success rate in IOP control than the CPC group(60%vs 21.4%,P=0.03).Both procedures significantly decreased the number of glaucoma medications(P=0.03).Forty percent and 57%of cases in the GDI and the CPC group,respectively,experienced endothelial graft failure during follow-up(P=0.36).Significantly worse BCVA after surgery was observed in the CPC group but not in the GDI group.CONCLUSION:Both GDI and CPC significantly decrease IOP in eyes with glaucoma after DSAEK.GDI is preferable to CPC in refractory glaucoma cases after DSAEK,as it manifests a significantly higher success rate for IOP control,similar endothelial graft failure rate,and relatively preserves BCVA than CPC.

关 键 词：glaucoma drainage device implantation CYCLOPHOTOCOAGULATION refractory glaucoma Descemetstripping automated endothelial keratoplasty 

分 类 号：R775[医药卫生—眼科]