Edward S. Harkness Institute, Columbia University Medical Center, New York, NY 10032, USA.
Cornea. 2012 Apr;31(4):350-8. doi: 10.1097/ICO.0b013e31823cbd29.
To evaluate corneal graft survival and intraocular pressure (IOP) control after penetrating keratoplasty (PK) and pars plana Ahmed Glaucoma Valve (AGV) implantation among patients with coexisting glaucoma and corneal disease.
Retrospective chart review at an institution of 25 eyes (24 patients) that received PK and pars plana AGV.
The mean postoperative follow-up was 23 months (range, 2-106 months). Survival of the grafts was 89% (16 of 18 eyes) at 1 year and 63% (5 of 8) at 2 years. IOP control was 78% (15 of 19) at 1 year and 44% (4 of 9) at 2 years. By Kaplan-Meier analysis, the 50% probability of sustained graft clarity occurred at 28 months and that of sustained IOP control at 24 months. By last follow-up, best-corrected visual acuity had improved by at least 1 line in 52% (13 of 25) of eyes compared with preoperative values. Preoperative factors, including peripheral anterior synechiae, were not found to be associated with graft survival, IOP control, or visual acuity at 1 year.
Pars plana AGV can successfully control IOP in PK patients in the short and intermediate terms, but graft clarity and IOP control diminish over time. Graft decompensation, when it did occur, likely reflects the associated ocular morbidity and clinical complexity of this circumscribed cohort of eyes.
评估穿透性角膜移植术（PK）联合巩膜睫状体平坦部 Ahmed 青光眼阀（AGV）植入术后合并青光眼和角膜疾病患者的角膜移植物存活率和眼内压（IOP）控制情况。
对某机构 24 例（25 只眼）患者接受 PK 联合巩膜睫状体平坦部 Ahmed 青光眼阀的回顾性病历分析。
术后平均随访时间为 23 个月（范围：2-106 个月）。术后 1 年，移植物存活率为 89%（16/18 只眼），2 年时为 63%（5/8 只眼）。术后 1 年，IOP 控制率为 78%（15/19 只眼），2 年时为 44%（4/9 只眼）。Kaplan-Meier 分析显示，移植物持续清晰的 50%概率发生在 28 个月，IOP 持续控制的 50%概率发生在 24 个月。末次随访时，与术前相比，52%（13/25 只眼）的最佳矫正视力至少提高了 1 行。术前因素（包括周边前粘连）与移植物存活率、IOP 控制或术后 1 年的视力均无相关性。
在短期内，巩膜睫状体平坦部 Ahmed 青光眼阀可成功控制 PK 患者的 IOP，但随着时间的推移，移植物的清晰度和 IOP 控制会逐渐下降。移植物失代偿，当它确实发生时，可能反映了这些有限的病例组眼睛的相关眼疾和临床复杂性。
