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Indian Journal of Clinical and Experimental Ophthalmology


Outcomes of Descemet’s stripping endothelial keratoplasty in patients with secondary glaucoma


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Research Article

Author Details : Anitha Venugopal*, Meenakshi Ravindran, Ramakrishnan Rengappa, Aditya Ghorpade

Volume : 5, Issue : 4, Year : 2019

Article Page : 447-451


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Abstract

Introduction: Aim of the study is to analyse the outcomes of Descemet’s stripping endothelial keratoplasty
(DSEK) for corneal oedema in patients with secondary glaucoma. Our’s is retrospective review of the
outcomes of DSEK that was performed for corneal decompensation in patients with secondary glaucoma.
Materials and Methods: A total of 93 patients, of which 17 had been diagnosed with secondary glaucoma,
were included in the study. All patients underwent medical or surgical treatment to control intraocular
pressure (IOP) before DSEK. The clinical outcomes of DSEK in these patients were evaluated. The
data collected included demographic patterns, indications, medical or surgical treatment for glaucoma,
intra-operative and post-operative complications of DSEK, IOP changes before and after DSEK, and
post-operative visual outcomes. The data were analysed based on the different aetiologies of secondary
glaucoma such as iridocorneal endothelial (ICE) syndrome, pseudoexfoliation (PXF) syndrome, glaucoma
in pseudophakia, traumatic glaucoma, and inflammatory glaucoma. The average IOP of each patient was
calculated using both applanation tonometry and Tono-pen before and after DSEK and at every follow-up.
Main Outcome Measures Graft clarity, IOP changes, and visual outcomes after DSEK were evaluated for all patients.
Results: DSEK was performed for the following causes of secondary glaucoma in descending order: PXF,
6 patients; ICE, 4 patients; glaucoma in pseudophakia, 3 patients; traumatic glaucoma, 2 patients; and
inflammatory glaucoma, 2 patients. Two patients underwent trabeculectomy, 5 patients underwent aqueous
tube drainage surgery, and 13 patients were administered medication before DSEK. At the 1-year followup,
14 patients had clear grafts with best corrected visual acuity (BCVA) scores greater than 6/36, while
the BCVA scores of the other 3 patients were below 6/60.
Conclusion: DSEK is an appropriate method for treating all types of secondary glaucoma. After DSEK,
the visual recovery, refractive outcomes are superior and the rise in IOP is minimal compared to those after
Full thickness Keratoplasty, since the angle anatomy and corneal contour is maintained.

Keywords: Descemet’s membrane endothelial keratoplasty, Secondary glaucoma.

Doi : 10.18231/j.ijceo.2019.107

How to cite : Venugopal A, Ravindran M, Rengappa R, Ghorpade A, Outcomes of Descemet’s stripping endothelial keratoplasty in patients with secondary glaucoma. Indian J Clin Exp Ophthalmol 2019;5(4):447-451

Copyright © 2019 by author(s) and Indian J Clin Exp Ophthalmol. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (creativecommons.org)