Post-keratoplasty glaucoma

Kirkness, C M; Moshegov, Con N

doi:10.1038/eye.1988.130

Cited by 69 publications

(49 citation statements)

References 25 publications

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“…The reported incidence of secondary glaucoma after PKP ranges 10-53%. [33][34][35][36][37] One subject (7.1%, Patient 13) suffered from secondary glaucoma with painful red eye and no light perception and received evisceration at 39 month follow-up.…”

Section: Resultsmentioning

confidence: 99%

Eye preservation tectonic graft using glycerol-preserved donor cornea

Hc¹,

Sj²,

Chao³

2012

Eye

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Aims To report the surgical outcome of tectonic graft using glycerol-preserved donor corneas to treat perforated keratitis. Methods The medical records were reviewed of all patients treated for perforated keratitis using glycerol-preserved corneas at a single institution between 1 July 2004 and 31 June 2010. The clinical features, precipitating factors, adjuvant therapies, and therapeutic outcomes were analyzed. Success was defined as re-epithelialization of the ocular surface without evisceration. Results Fourteen eyes from 14 patients (6 male and 8 female) were included. Age ranged from 58 to 84 years (average, 70.71±8.52 years) and the follow-up time ranged from 7 to 56 months (mean, 25.35 ± 16.84 months). The culture results showed five bacterial infections, five cases of fungal keratitis, and one mixed infection; the culture results were negative for three patients. Satisfactory anatomical integrity was obtained in eight grafts (57.14%) that healed with neovascularization. Six grafts (48.85%) showed delayed re-epithelialization and were repaired with conjunctival flaps to maintain ocular surface integrity. Three patients developed secondary glaucoma and received trans-scleral cyclophotocoagulation. Thirteen patients had satisfactory anatomical integrity without evisceration or exenteration, while one patient received evisceration at 39-month follow-up because of intractable glaucoma. Conclusions Glycerol-preserved donor corneas combined with anterior vitrectomy with or without conjunctival flaps may be effective substitutes for evisceration surgery in patients with perforated keratitis.

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Section: Resultsmentioning

confidence: 99%

Eye preservation tectonic graft using glycerol-preserved donor cornea

Hc¹,

Sj²,

Chao³

2012

Eye

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“…Multiple studies found a high correlation between PAS and IOP elevation after PK and post-PK glaucoma [7,16,17,18,19,20,21,22]. After DSEK, steroid-related ocular IOP elevation was identified as a major cause [1,13].…”

Section: Introductionmentioning

confidence: 99%

“…Durable uncontrolled elevation of IOP and manifest post-keratoplasty glaucoma are major risk factors for poor visual outcome, endothelial cell loss and subsequent graft failure after keratoplasty. After penetrating keratoplasty (PK), an increasing incidence of IOP elevation from 29 to 80% was reported [1,2,3,4,5,6,7]. Post-PK glaucoma occurred in 9-35% of cases [2,6,8,9,10,11].…”

Section: Introductionmentioning

confidence: 99%

Anterior Segment Analysis and Intraocular Pressure Elevation after Penetrating Keratoplasty and Posterior Lamellar Endothelial Keratoplasty

et al. 2014

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Background: Peripheral anterior synechiae (PAS) is a common problem after penetrating keratoplasty (PK) and leads to intraocular pressure (IOP) elevation. This study examines the risk factors for IOP elevation and post-keratoplasty glaucoma. Methods: A retrospective analysis was performed of 47 eyes following PK and of 65 eyes following Descemet's stripping endothelial keratoplasty (DSEK) between 2009 and 2011. The assessment included preoperative history of corneal disease and glaucoma, response to treatment, IOP, and visual acuity. Irido-trabecular contacts (ITC), the angle opening distance (AOD 500) and the anterior chamber angle (ACA 500) were calculated. Results: The incidences of IOP elevation and post-keratoplasty glaucoma were 27-36% and 10-29%, respectively. The incidence did not differ significantly between both procedures. Pre-existing glaucoma increased the risk for developing IOP elevation and post-DSEK glaucoma. Eyes with bullous keratopathy (BK) developed significantly more IOP elevation (p = 0.01, d.f. = 1, χ² = 6.11) and post-keratoplasty glaucoma (p = 0.01, d.f. = 1, χ² = 6.22) than eyes with Fuchs' endothelial dystrophy. Eyes with ITC developed post-keratoplasty glaucoma significantly more often than eyes without ITC (p = 0.01, d.f. = 1, χ² = 6.63). Conclusion: IOP elevation and post-keratoplasty glaucoma showed a high incidence. Risk factors like pre-existing glaucoma, BK and PAS elevated the rate of IOP elevation and post-keratoplasty glaucoma for both procedures. © 2014 S. Karger AG, Basel

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“…2,3 The incidence of glaucoma after keratoplasty varies from 9% to 31% in the early postoperative period and from 18 to 35% in the late postoperative period. 4,5 The aetiology of this disorder is multifactorial and the clear understanding of the various mechanisms that operate during different time frames following penetrating keratoplasty is essential to chalk out the appropriate management algorithms.…”

Section: Introductionmentioning

confidence: 99%

Preoperative risk factors and incidence of glaucoma after penetrating keratoplasty

Mn¹,

G²,

Hulinaykar³

et al. 2014

Int J Clin Trials

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Background: Glaucoma following penetrating keratoplasty is one of the serious complications due to its frequency of occurrence, difficulty in diagnosis and management, risk of graft failure and irreversible visual loss due to optic nerve damage. The incidence of glaucoma after keratoplasty varies from 9% to 31% in the early postoperative period and from 18 to 35% in the late postoperative period. The aetiology of this disorder is multifactorial and the clear understanding of the various mechanisms that operate during different time frames following penetrating keratoplasty is essential to chalk out the appropriate management algorithms. Methods: Prospective analysis of 100 consecutive eyes which underwent penetrating keratoplasty during the period from September 2009 to December 2010 at Bangalore West Lions super speciality eye hospital was done. The patients were followed up for a minimum period of 9 months. Results: Out of 100 patients mean age distribution was 47 ± 11 years. Of the 100 patients male 68% and 32 female (32%). Out of 100 eyes 38% of them had vision <6/60, 36% of them had vision between 6//36-6/18 and 26% of them between 6/18-6/6. Raised intraocular pressure was found in 15 out of 100 eyes. Mean raise in intraocular pressure was 29 mmHg ± 1.5 mmHg. Out of 15 patients 4 were steroid responders. Mean time of diagnosis of raised intraocular pressure was 5 ± 9.5 months. Pseudophakic Bullous Keratopathy (PBK) in 5 (33.3%) patients, aphakic bullous keratopathy (ABK) in 3 (20%) patients, graft rejection in 2 (13.3%) patients and one each patient (6.7%) of corneal scar, adherent leucoma, chemical injury and congenital hereditary endothelial dystrophy. Aphakic group was at higher risk compared to the other groups and there was not much difference between the phakic and the pseudophakic group. Conclusions: Post penetrating keratoplasty glaucoma continues to be a clinical problem that can be sight threatening in its clinical outcome. It is mandatory that intraocular pressure is monitored on a regular basis. Recognition of the risk factors namely, indications, graft size, lenticular status & associated surgical procedure with penetrating keratoplasty would help in early diagnosis of post penetrating keratoplasty glaucoma. Most of these cases are amenable to medical management.

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Post-keratoplasty glaucoma

Cited by 69 publications

References 25 publications

Eye preservation tectonic graft using glycerol-preserved donor cornea

Eye preservation tectonic graft using glycerol-preserved donor cornea

Anterior Segment Analysis and Intraocular Pressure Elevation after Penetrating Keratoplasty and Posterior Lamellar Endothelial Keratoplasty

Preoperative risk factors and incidence of glaucoma after penetrating keratoplasty

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