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Combined penetrating keratoplasty and trabeculectomy with mitomycin C
D WuDunn1, E Alfonso, P F Palmberg
1Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida, USA.
Objective:
To evaluate corneal graft survival and intraocular pressure control in eyes that have undergone combined penetrating keratoplasty and trabeculectomy with mitomycin C (MMC).
Design:
Retrospective noncomparative case series.
Intervention:
Penetrating keratoplasty combined with trabeculectomy with MMC and other surgical procedures.
Participants:
Twenty-four eyes of 22 patients undergoing combined penetrating keratoplasty and trabeculectomy with mitomycin C.
Main Outcome Measures:
Corneal graft clarity and intraocular pressure control.
Results:
The cumulative probability of corneal graft survival was 85% at 1 year and 60% at 2 years. The cumulative probability of adequate pressure control was 67% at 3 months, 55% at 12 months, and 50% at 24 months. The incidence of bleb failure was higher in cases involving additional concomitant procedures, such as anterior vitrectomy, lens implantation or exchange, and drainage tube implantation.
Conclusions:
Combined penetrating keratoplasty and trabeculectomy with mitomycin C is associated with good corneal graft survival but also a risk of early failure of intraocular pressure control. Other concomitant procedures during the combined penetrating keratoplasty/trabeculectomy may increase the risk of early bleb failure.