CORNEA 34 EWAP SEPTEMBER 2023 collaborate and communicate on whether a steroid drop needs to be reduced or postponed or if additional glaucoma management should be added. “If the IOP is not controlled by medication, additional glaucoma surgery might be necessary,” Dr. Deng said. Finally, Dr. Sorkin said that glaucoma patients need to be counseled about some different things. First, he said it should be very clear that they need to continue their glaucoma regimen even after the addition of steroid drops; he said patients can sometimes become confused and discontinue one for the other. Second, he said there is a need to understand the high long-term failure rate of grafts when patients have a trab or tube. “They need to know there is a high chance the graft will fail every few years, and they’ll need to get repeat grafts. You need to have that conversation with the patient so that they know what to expect,” Dr. Sorkin said. EWAP References 1. Gagnon MM, et al. Corneal endothelial cell density in glaucoma. Cornea. 1997;16:314 – 318. 2. Alshaker S, et al. Four-year survival comparison of endothelial keratoplasty techniques in patients with previous glaucoma surgery. Cornea. 2021;40:1282–1289. 3. Aravena C, et al. Outcomes of Descemet membrane endothelial keratoplasty in patients with previous glaucoma surgery. Cornea. 2017;36:284–289. 4. Bonnet C, et al. Long-term outcomes of Descemet membrane endothelial keratoplasty in eyes with prior glaucoma surgery. Am J Ophthalmol. 2020;218:288–295. Editors’ note: Dr. Deng is Joan and Jerome Snyder Chair in Cornea Diseases Cornea Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, and declared no relevant financial interests. Dr. Sorkin is Director of Cornea and Anterior Segment Research, Department of Ophthalmology, Tel Aviv Medical Center and Tel Aviv University, Tel Aviv, Israel, and has interests with Beyeonics. A phakic patient with two prior shunts 1 week after DMEK. Source: Sophie Deng, MD, PhD
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