Corneal Decompensation After Shunt Surgery: Case Series
Purpose
To determine the role of Ex-Press shunt placement in the development of corneal decompensation and evaluate post-operative visual outcomes.
Methods
A retrospective chart review was performed of all corneal transplants by one surgeon to treat corneal decompensation after prior Ex-Press shunt surgery between April 2008 to January 2014. Data collected included past ocular history, best corrected visual acuity (BCVA) before and after transplantation, time of onset of corneal decompensation after Ex-Press shunt surgery, and topical medications.
Results
7 eyes of 6 patients (66.7% female, mean age 83.9 ± 10.4 years) were identified; 6 had primary open angle glaucoma and 1 had chronic angle closure glaucoma. The average time of onset of corneal decompensation after Ex-Press shunt implantation in the 4/7 patients where the exact date of Ex-Press shunt placement was known was 1.9 ± 2.1 years. Surgeries performed included Descemet’s stripping endothelial keratoplasty in 5 patients, Descemet membrane endothelial keratoplasty in one, and penetrating keratoplasty in one. Postoperatively, BCVA was available in 6/7; 5/7 had greater than 3 lines of improvement 1/7 had one line of improvement.
Conclusion
There are no publications reporting corneal decompensation after Ex-Press shunt placement. Long term follow up is needed to determine the role of the device itself in causing corneal decompensation. This case series demonstrates that corneal transplantion is successful in the treatment of corneal decompensation after Ex-Press valve placement.