The long-term reult of keratoplaty in eye with a glaucoma drainage device

Purpoe To tudy the outcome of penetrating keratoplaty (PK) in eye with a glaucoma drainage device (GDD). Deign Retropective cae-controlled tudy. Method We reviewed all patient who underwent PK from December 1986 to eptember 2002 at the Univerity of California, Davi (n = 1,974). We identified 33 patient (40 graft) who were treated with a GDD and followed up for 6 month or more after PK. Graft urvival and glaucoma control were compared with graft in patient without glaucoma (n = 40) and patient with medically controlled glaucoma (n = 17). Kaplan-Meier urvival analyi, log rank tet, repeated-meaure analyi of variance (ANOVA), Fiher exact tet, and χ2 were ued in group comparion. Multivariate analyi wa performed uing the Cox proportional hazard model. Reult The percentage of clear graft in the glaucoma drainage device group were 58.5% and 25.8% at 1 and 2 year, repectively. At thee time point, glaucoma wa controlled in 74.0% and 63.1% of the eye, repectively. Both medically controlled glaucoma patient and nonglaucomatou patient had higher graft urvival percentage at comparable time point. The preence of a GDD wa an important factor influencing graft urvival (Hazard ratio = 6.8). Concluion A GDD implant i an independent rik factor for graft failure. Although thee device are effective in controlling intraocular preure (IOP) in the majority of eye in the preence of PK, corneal graft clarity i often compromied.