Kim Emmeline J, Ertel Monica K, Patnaik Jennifer L, Mayeda Maxwell, Peter Deidre St, Deitz Galia A, SooHoo Jeffrey R, Pantcheva Mina B, Kahook Malik Y, Seibold Leonard K, Christopher Karen L, Capitena Young Cara E
Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Ct, F731, Aurora, CO, 80045, USA.
Ophthalmol Ther. 2025 Jun;14(6):1297-1309. doi: 10.1007/s40123-025-01145-8. Epub 2025 Apr 23.
This study aimed to evaluate the rate of corneal graft failure in eyes with glaucoma drainage device (GDD) placed in the anterior chamber (AC) versus the ciliary sulcus (CS).
This was a retrospective chart review of eyes with coexisting corneal transplant and GDD between January 2014 and December 2021 at an academic medical center. The primary outcome was incidence of corneal transplant failure. Groups were compared with logistic regression modeling utilizing generalized estimating equations with an unstructured correlation to account for patients with two eyes included. Adjusted odds ratios (OR) and 95% confidence limits were determined for the primary outcome. Kaplan-Meier curves were used to demonstrate the time to failure.
Among 58 eyes, the graft failure rate for GDDs placed in the AC versus CS was 42.5% and 10.5%, respectively (p = 0.05). Male patients had higher odds of failure, OR 3.5 (95% CI 1.1, 10.4, p = 0.03). Maximum intraocular pressure, topical carbonic anhydrase inhibitor use, and type of corneal graft were not significantly associated with failure. The Kaplan-Meier survival curve demonstrated higher corneal transplant failure probabilities for eyes with GDD in the AC versus CS (p = 0.06). GDD location, after adjusting for sex, was not significantly associated with failure, OR 3.0 (95% CI 0.8, 11.6, p = 0.10).
Corneal transplant failure rates were four times higher in eyes with GDDs in the AC compared to the CS, but the difference was not statistically significant. Further studies with larger sample sizes and follow-up are needed to fully explore differences in failure rates by GDD placement.
本研究旨在评估在前房（AC）与睫状沟（CS）植入青光眼引流装置（GDD）的眼睛中角膜移植失败的发生率。
这是一项对2014年1月至2021年12月在一家学术医疗中心同时进行角膜移植和GDD植入的眼睛的回顾性病历审查。主要结局是角膜移植失败的发生率。利用广义估计方程和非结构化相关性进行逻辑回归建模，对两组进行比较，以纳入双眼患者。确定主要结局的调整优势比（OR）和95%置信区间。采用Kaplan-Meier曲线来显示失败时间。
在58只眼中，AC组与CS组GDD植入后的移植失败率分别为42.5%和10.5%（p = 0.05）。男性患者失败的几率更高，OR为3.5（95%CI 1.1, 10.4，p = 0.03）。最大眼压、局部碳酸酐酶抑制剂的使用以及角膜移植的类型与失败无显著相关性。Kaplan-Meier生存曲线显示，AC组GDD植入眼的角膜移植失败概率高于CS组（p = 0.06）。在调整性别后，GDD的位置与失败无显著相关性，OR为3.0（95%CI 0.8, 11.6，p = 0.10）。
AC组植入GDD的眼睛角膜移植失败率比CS组高四倍，但差异无统计学意义。需要进行更大样本量和更长随访时间的进一步研究，以充分探讨GDD植入位置对失败率的影响差异。
