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Abstract #24397 Published in IGR 11-3
Selective laser trabeculoplasty for glaucoma after penetrating keratoplasty
Nakakura S; Imamura H; Nakamura TOptometry and Vision Science 2009; 86: e404-406
PURPOSE: Postoperative intraocular pressure elevation is the most common complication to occur after penetrating keratoplasty (PKP). When topical antiglaucoma drops or oral systemic medication cannot lower this pressure, surgical intervention is necessary. However, surgery cannot yet be performed that does not adversely affect the graft, and better surgical treatments are required. METHODS: A 62-year-old man had undergone PKP to treat bullous keratopathy in the left eye. Secondary glaucoma occurred early postoperation and was controlled through topical antiglaucoma eye drops, medication, and the decreasing use of topical steroids. However, 7 months postsurgery, intraocular pressure (IOP) in the eye re-elevated to 42 mm Hg (Goldmann applanation tonometer). Selective laser trabeculoplasty was performed inferiorly for 6 h and then added selective laser trabeculoplasty performed superiorly for 6 h, 1 week later. Complete slit lamp biomicroscopy, visual acuity, IOP, gonioscopy, and mydriatic funduscopy were performed pre- and posttreatment for 6 months. RESULTS: IOP decreased from 42 to 27 mm Hg 1 week after selective laser trabeculoplasty (SLT) (inferior 180 degrees). After an additional superior 180 degrees SLT performed 2 weeks after this, IOP decreased to 15 mm Hg. Six months later, IOP was stable at 18 mm Hg, and graft rejection, new peripheral anterior synechiae, and visual acuity disturbance were not observed. CONCLUSIONS: IOP elevation after PKP was successfully treated with SLT. SLT will become a valuable therapeutic method that limits invasive surgery for treatment of secondary glaucoma after PKP.
Dr. S. Nakakura, Department of Ophthalmology, Saiseikai Gose Hospital, Mimuro, Gose, Japan. shunsukenakakura@yahoo.co.jp
Classification:
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
