Graft Survival Versus Glaucoma Treatment After Penetrating or Descemet Stripping Automated Endothelial Keratoplasty
Graft Survival Versus Glaucoma Treatment After Penetrating or Descemet Stripping Automated Endothelial Keratoplasty
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DOI：
10.1097/ico.0000000000000170
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发表时间：
2014-08-01
期刊：
影响因子：
2.8
通讯作者：
Wagoner, Michael D.
中科院分区：
文献类型：
--
作者：
Ward, Matthew S.;Goins, Kenneth M.;Wagoner, Michael D.
目的：本研究的目的是评估和比较进行穿透性角膜移植术（PKP）和后弹力层剥离自动内皮角膜移植术（DSAEK）后青光眼治疗与移植物存活的关系。方法：对病例进行回顾性图表审查：2003年1月1日至2005年12月31日期间的原发性PKP，或2006年1月1日至2006年1月1日期间的原发性DSAEK。 2008年12月31日。具有人工晶状体角膜水肿手术指征的眼睛被纳入统计分析。根据青光眼治疗将眼睛分为（1）未接受青光眼治疗、（2）仅接受药物治疗或（3）接受手术干预的眼睛。主要结果指标是移植物存活率。结果：57 只 PKP 手术眼和 156 只 DSAEK 手术眼符合纳入标准。 PKP和DSAEK后，未接受青光眼治疗的眼睛的5年Kaplan-Meier移植物存活率分别为94.7%和93.8%（P > 0.99），仅接受药物治疗的眼睛为93.8%和96.3%（P > 0.99），接受手术干预的眼睛为56.8%和50%（P > 0.99）。进行这两种手术后，与未接受青光眼治疗的眼睛 (P < 0.0001) 或仅接受药物治疗的眼睛 (P < 0.0001) 相比，接受手术干预的眼睛的移植物存活率明显较差。结论：PKP 和 DSAEK 在未接受青光眼治疗的眼睛和接受类似青光眼治疗的眼睛中具有相当的移植物存活率。
Purpose: The aim of this study was to assess and compare the association of glaucoma therapy with graft survival after performing penetrating keratoplasty (PKP) and Descemet stripping automated endothelial keratoplasty (DSAEK).Methods: A retrospective chart review was performed of cases: primary PKP from January 1, 2003, to December 31, 2005, or primary DSAEK from January 1, 2006, to December 31, 2008. Eyes with a surgical indication of pseudophakic corneal edema were included in the statistical analysis. Eyes were stratified by glaucoma treatment into those with (1) no glaucoma treatment, (2) medical therapy only, or (3) surgical intervention. The main outcome measure was graft survival.Results: Fifty-seven PKP-operated and 156 DSAEK-operated eyes met the inclusion criteria. After PKP and DSAEK, respectively, the 5-year Kaplan-Meier graft survival was 94.7% and 93.8% in eyes with no glaucoma treatment (P > 0.99), 93.8% and 96.3% in eyes with medical therapy only (P > 0.99), and 56.8% and 50% in eyes with surgical intervention (P > 0.99). After both procedures were performed, graft survival was significantly worse in eyes with surgical intervention compared with that in eyes with no glaucoma treatment (P< 0.0001) or in eyes with medical therapy alone (P < 0.0001).Conclusions: PKP and DSAEK have comparable graft survival in eyes without glaucoma management and in those with comparable glaucoma management.