Glaucoma management after corneal transplantation surgeries

Kornmann, Helen L.; Gedde, Steven J.

doi:10.1097/icu.0000000000000237

Cited by 38 publications

(34 citation statements)

References 98 publications

(132 reference statements)

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“…In addition, the incidence of graft rejection and graft infection in the PKP group was significantly higher than that in the simplified DSEK group and these two complications tend to lead to secondary graft failure (18). Glaucoma is one of the most common complications after corneal transplantation and the degree of damage is generally linked to the surgical method, particularly PKP, DSEK and Boston artificial corneal transplantation (19). The postoperative incidence was 33.33%, which was consistent with that of previous studies (13,19,20).…”

Section: Discussionmentioning

confidence: 99%

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Comparative observation of the efficacy of simplified Descemet stripping endothelial keratoplasty and penetrating keratoplasty in treating bullous keratopathy

et al. 2020

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The aim of the present study was to compare the clinical efficacy between simplified Descemet stripping endothelial keratoplasty (DSEK) and penetrating keratoplasty (PKP) in the treatment of patients with bullous keratopathy (BK). A cohort of 65 patients (65 eyes) with BK recruited between December 2002 and June 2018 was divided into two groups according to the treatment they received: The simplified DSEK group (n=38) and the PKP group (n=27). The best-corrected visual acuity (BCVA) during the follow-up at 1, 3, 6 and 12 months and postoperative complications were all recorded. Furthermore, the graft survival rate after 1 year was recorded. The mean BCVA in the simplified DSEK group was significantly better than that in the PKP group after 1, 3, 6 and 12 months (P<0.05). Furthermore, the 1-year graft survival rate in the simplified DSEK group (91.2%) was significantly higher than that in the PKP group (70.4%; P= 0.039). A total of 13 eyes (34.21%) in the simplified DSEK group and 11 eyes (40.74%) in the PKP group were diagnosed with glaucoma; there was no significant difference between the rate of glaucoma diagnosis between the two groups (P=0.591). Graft rejection was observed in 5 eyes (13.16%) of the simplified DSEK group and 8 eyes (29.63%) of the PKP group and the rate of graft rejection did not differ significantly between the groups (P= 0.279). Graft infection occurred in 1 eye (2.63%) in the simplified DSEK group and 6 eyes (22.22%) in the PKP group. Simplified DSEK achieved better visual acuity and longer graft survival rates than PKP. The incidence of postoperative secondary glaucoma, graft rejection and graft infection after simplified DSEK was lower than that in the PKP group, but only the incidence of graft infection was significantly different.

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Section: Discussionmentioning

confidence: 99%

“…Glaucoma is one of the most common complications after corneal transplantation and the degree of damage is generally linked to the surgical method, particularly PKP, DSEK and Boston artificial corneal transplantation ( 19 ). The postoperative incidence was 33.33%, which was consistent with that of previous studies ( 13 , 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

Comparative observation of the efficacy of simplified Descemet stripping endothelial keratoplasty and penetrating keratoplasty in treating bullous keratopathy

et al. 2020

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“…Also, glaucoma after corneal graft surgery can potentially lead to visual loss and graft failure [17]. The risk of developing glaucoma after a penetrating keratoplasty ranges from 5.5-31% in the early postoperative period and can be as high as 17-35% in the late postoperative period [18]. Patients with peripheral anterior synechiae are at high risk for developing glaucoma [18].…”

Section: Case Reports In Ophthalmological Medicinementioning

confidence: 99%

“…The risk of developing glaucoma after a penetrating keratoplasty ranges from 5.5-31% in the early postoperative period and can be as high as 17-35% in the late postoperative period [18]. Patients with peripheral anterior synechiae are at high risk for developing glaucoma [18]. Additionally, in a retrospective study on patients with fragile corneas, it was found that 50% of pediatric patients developed glaucoma after penetrating keratoplasty [19].…”

Section: Case Reports In Ophthalmological Medicinementioning

confidence: 99%

Case Series of Brittle Cornea Syndrome

Eleiwa

Raheem

Patel

et al. 2020

Case Reports in Ophthalmological Medicine

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Purpose. This case series demonstrate diagnostic features, treatment options, and challenges for Brittle Cornea Syndrome. Observations. Three cases presented with bluish sclera and extremely thin cornea. Genetic workup was performed and confirmed the diagnosis of Brittle Cornea Syndrome, a rare autosomal recessive disorder characterized by corneal thinning and blue sclera. Case 1 was a 4-year-old boy who developed cataract and glaucoma after undergoing right tectonic penetrating keratoplasty (PK) secondary to a spontaneous corneal rupture. Glaucoma was controlled medically. Later, the kid underwent right transcorneal lensectomy and vitrectomy with synechiolysis. After 6 weeks, he sustained graft dehiscence that was repaired using onlay patch graft. Case 2 was a 7-year-old boy who underwent PK in the right eye, then a pericardial patch graft in the left eye following spontaneous corneal rupture. Glaucoma in both eyes was controlled medically. Case 3 was the 2-year-old sister of the 2nd case. She had a pachymetry of 238 μm OD and 254 μm OS. In the 3 cases, parents were instructed to take protective measures for both eyes and to continue with follow-up visits. Also, they were instructed to have regular screenings for late-onset hearing loss, dental abnormalities, and bone deformities. Conclusions. Long-term follow-up of children diagnosed with Brittle Cornea Syndrome is paramount to minimize the morbidity of corneal rupture and late-onset extraocular conditions.

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“…The progression of glaucoma following corneal transplantation is a well-known source of ocular morbidity [ 1 ]. The common causes of postkeratoplasty intraocular pressure (IOP) elevation are synechial angle closure [ 2 ] and the need for chronic corticosteroid use [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes of Micropulse Transscleral Cyclophotocoagulation in Patients with a History of Keratoplasty

Lee

Lazcano‐Gomez

et al. 2020

Journal of Ophthalmology

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Purpose. To examine the surgical outcomes and graft conditions in patients receiving micropulse transscleral cyclophotocoagulation (MP-TSCPC) to treat post-keratoplasty ocular hypertension. Methods. This retrospective observational study included 30 eyes of 28 consecutive glaucoma patients with a history of penetrating keratoplasty (PKP) or Descemet’s stripping automated endothelial keratoplasty (DSAEK) who underwent MP-TSCPC at the University of California, San Francisco from 09/2015 to 08/2018. Using the Wilcoxon signed-rank test, we compared preoperative and postoperative intraocular pressure (IOP), number of glaucoma medications, visual acuity, and central corneal thickness at 1, 3, 6, and 12 months. Postoperative complications, additional surgeries, and graft failures were also recorded at these follow-up times. Linear regression model was used to study whether PKP vs. DSAEK affects the effectiveness of MP-TSCPC. Results. Thirty eyes from 28 patients were followed for 12 months. IOP was significantly decreased from preop at all follow-up points (P<0.001). There was no significant change in the number of glaucoma drops, visual acuity, or CCT. At 12 months, 21 of the 30 eyes met the definition of success, and only one underwent repeat PKP due to graft rejection. The type of corneal transplant was not a significant factor for IOP reduction at the last follow-up. Conclusions. MP-TSCPC achieved desirable IOP control and success rates for postkeratoplasty patients while resulting in minimal complications and graft failure. It appears to be a safe and effective procedure in patients who received corneal transplant with one-year follow-up.

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Glaucoma management after corneal transplantation surgeries

Cited by 38 publications

References 98 publications

Comparative observation of the efficacy of simplified Descemet stripping endothelial keratoplasty and penetrating keratoplasty in treating bullous keratopathy

Comparative observation of the efficacy of simplified Descemet stripping endothelial keratoplasty and penetrating keratoplasty in treating bullous keratopathy

Case Series of Brittle Cornea Syndrome

Clinical Outcomes of Micropulse Transscleral Cyclophotocoagulation in Patients with a History of Keratoplasty

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