Glaucoma Mini-Shunt Implantation After Keratoplasty

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Corneal Transplantation

Background:

• Secondary glaucoma following keratoplasty presents a significant challenge in managing intraocular pressure (IOP).
• Conventional glaucoma surgeries may pose risks to the integrity of the transplanted cornea.

Purpose of the Study:

• To evaluate the outcomes of miniature glaucoma shunt implantation in patients who developed secondary glaucoma after keratoplasty.
• To assess the efficacy and safety of the Ex-PRESS P-50 model in this specific patient population.

Main Methods:

• A prospective study included 17 eyes of 17 patients undergoing mini-glaucoma shunt implantation after various types of keratoplasty.
• The surgical technique involved a fornix-based conjunctival flap, scleral flap, Mitomycin C application, and insertion of the Ex-PRESS P-50 shunt.
• Statistical analysis was performed using STATA 8.0 and SPSS software.

Main Results:

• Mean preoperative IOP was 35.94 mm Hg, significantly reduced to 12.76 mm Hg postoperatively (P=0.001).
• Mean follow-up was 23.76 months.
• Both uncorrected and corrected distance visual acuity showed significant improvement post-surgery (P=0.001 and P=0.032, respectively).

Conclusions:

• Ex-PRESS miniature glaucoma shunt implantation is a successful alternative treatment for postkeratoplasty glaucoma resistant to medical therapy.
• This technique may help avoid corneal damage associated with traditional glaucoma procedures.