News reports from the conference

New approach bests conventional therapy for patients with glaucoma and corneal edema requiring surgery

Descemet's stripping with automated endothelial keratoplasty (DSAEK) appears to be superior to traditional penetrating keratoplasty (PKP) for patients with pre-existing glaucoma and corneal edema requiring surgery, a retrospective chart review suggests.

University of Western Ontario ophthalmology resident Dr. Lulu Bursztyn who presented the research noted that while PKP is known to potentially worsen intraocular pressure (IOP) and glaucoma, current? case report data for DSAEK does not provide definitive information and no direct comparisons are available for the two approaches.

This retrospective study evaluated the two approaches in 98 eyes (with full-thickness PKP and 47 with DSAEK) operated on by the same surgeon at the Ivey Eye Institute in London, Ontario between 2003 and 2010.

No significant differences were reported in mean pre-operative IOP in the eyes undergoing PKP when compared with those undergoing DSAEK. However, IOP was significantly higher at four weeks and 12 weeks post-operatively in the PKP eyes (p < 0.05). Pressure normalized by 26 weeks postoperatively in both groups.

Significantly more topical medications were required by patients undergoing PKP (p < 0.05) compared to patients who underwent DSAEK, and use of oral medications was similar between the two groups.

While 8% of patients undergoing PKP required further surgery to manage glaucoma, this was not the case for any patients who had DSAEK.

As a result of these findings, Bursztyn said that the research team, which included Elizabeth Golesic, Rookaya Mather and David Tingey, concluded that DSAEK appears to be a better option for patients with pre-existing glaucoma and corneal edema requiring keratoplasty.