Long-Term Results Of Eyes With A Corneal Transplantation And A Glaucoma Drainage Device: A Dutch Retrospective Multicenter Study
Published 2026 - 44th Congress of the ESCRS
Reference: PP11.07 | Type: Free paper | DOI: 10.82333/yv1f-cn81
Authors: Dr Yexin Ye* 1 , Dr Đana Tursunovic 2 , Dr Suryan Dunker 1 , Dr Bjorn Winkens 3 , A/Prof. Nomdo Jansonius 4 , Dr Robert Wijdh 4 , Dr Rogier Müskens 4 , Dr Tos Berendschot 1 , Dr Frank van den Biggelaar 1 , A/Prof. Henny Beckers 2 , A/Prof. Mor Dickman 5
1University Eye Clinic Maastricht, Maastricht University Medical Center+,Maastricht,Netherlands;Mental Health and Neuroscience Research institute (MHeNs), Maastricht University,Maastricht,Netherlands, 2University Eye Clinic Maastricht, Maastricht University Medical Center+,Maastricht,Netherlands, 3Department of Methodology and Statistics, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University,Maastricht,Netherlands, 4Department of Ophthalmology, University of Groningen, University Medical Center Groningen,Groningen,Netherlands, 5University Eye Clinic Maastricht, Maastricht University Medical Center+,Maastricht,Netherlands;Mental Health and Neuroscience Research institute (MHeNs), Maastricht University,Maastricht,Netherlands;Department of Ophthalmology, University Medical Center Utrecht,Utrecht,Netherlands
Purpose
To evaluate clinical outcomes in eyes with corneal transplantation and glaucoma drainage device (GDD) implantation.
Setting
Multicenter retrospective case series.
Methods
This retrospective case series included 137 eyes that underwent both corneal transplantation and GDD implantation at two tertiary centers in the Netherlands between October 2002 and March 2021. Patients were divided into two groups: Prior GDD (GDD before keratoplasty) and Subsequent GDD (GDD after keratoplasty). Medical charts were reviewed for baseline characteristics and clinical outcomes. The primary outcome measure was graft survival. Secondary outcomes included intraocular pressure (IOP), IOP-lowering drug use, best-corrected visual acuity (BCVA), and postoperative complications. Statistical analyses included Kaplan-Meier, Cox regression, and linear mixed models.
Results
Graft survival was significantly lower in the Prior GDD group compared to the Subsequent GDD group at 2 years (72% vs. 95%) and 5 years (47% vs. 74%) (P<0.001). IOP success at 2 years was 94% in the Prior GDD and 97% in the Subsequent GDD group. Trends in IOP, IOP-lowering drugs, and BCVA differed significantly between groups (all P<0.001). In the Prior GDD group, IOP and drug use remained stable, while BCVA improved significantly from 1.76 to 1.01 logMAR at 3 months (P<0.001). In the Subsequent GDD group, IOP decreased from 28.3 to 13.3 mmHg at 3 months (P<0.001), and drug use dropped from 4 to 2 agents (P<0.001), while BCVA remained stable. Postoperative complications occurred in 25% of eyes, with no significant difference between groups.
Conclusions
Graft survival was significantly lower in eyes with Prior GDD compared to Subsequent GDD. Nevertheless, favorable long-term IOP control and visual outcomes were achieved regardless of procedural sequence, with a low overall complication rate. These findings underscore the importance of careful surgical sequencing in patients requiring both corneal transplantation and GDD to optimize outcomes.