Ocular hypertension and glaucoma after penetrating keratoplasty

Abstract

Purpose

To report the incidence of glaucoma or ocular hypertension after PK and to determine the risk factors and treatment outcomes.

Methods

The medical records of 381 eyes of 365 patients who underwent penetrating keratoplasty were retrospectively reviewed. The recorded IOP values of the patients during the follow-up period were analyzed. Trabeculectomy was performed in cases of elevated IOP despite maximum medical treatment, and AGV implantation was performed in refractory cases.

Results

381 eyes of 365 patients, 223 (58.5%) male and 158 (41.5%) female, aged between 18–86 (mean 56.0 ± 18.0) were included in the study. The mean follow-up period was 12–126 months (mean 46.3 ± 28.6). During the follow-up period, post-PK OHT/glaucoma developed after PK in 179 eyes (47.0%). The mean development of OHT/glaucoma after PK was 6.3 ± 11.0 months. Postoperative follow-up IOP > 21 mmHg eye count was 177. The mean postoperative IOP values of these eyes were 27.0 ± 5.9 mmHg. Older recipient age (>50years), elevated preoperative IOP, history of glaucoma in the fellow eye,previous cataract surgery, donor—recipient trephine diameter mismatch otherthan 0.25 mm, larger donor trephine diameter, and additional intraoperative procedures—such as scleral fixation, intraocular lens implantation, anterior vitrectomy,and goniosynechiolysis—were identified as risk factors associated with glaucoma after penetrating keratoplasty.

Conclusions

Determining the risk factors that play a role in the development of OHT/glaucoma after PK, close follow-up of postoperative IOP elevations, and treatment if necessary can preserve visual function and graft transparency for a longer period of time.