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Abstract #49241 Published in IGR 14-1
Long term risk of intraocular pressure elevation and glaucoma escalation after deep anterior lamellar keratoplasty
Musa FU; Patil S; Rafiq O; Galloway P; Ball J; Morrell AClinical and Experimental Ophthalmology 2012; 40: 780-785
BACKGROUND: To determine the prevalence and severity of intraocular pressure (IOP) changes after deep anterior lamellar keratoplasty (DALK) and its effect on visual function. DESIGN: Retrospective cohort study PARTICIPANTS: All patients undergoing DALK procedures at a tertiary referral centre (Leeds University Hospitals, UK) using a manual dissection technique METHODS: Case note review of all cases between the 1(st) of January 2000 and the 31(st) of December 2005 MAIN OUTCOME MEASURES: Raised intraocular pressure (IOP), glaucoma incidence or escalation RESULTS: Data was collected for 69 of eyes of 58 patients. The mean period of follow-up was 54.9 months (median 60; range 6 to 95 months). The initial diagnosis was keratoconus (KC) in 56 cases (81%); corneal scarring in 4 cases (5.8%); herpes simplex keratitis in 4 cases (5.8%); lattice dystrophy in 4 cases (5.8%); and 1 case of corneal dermoid. Temporarily IOP was thought to be related to topical steroid use occurred in 12 (17%) cases. Sustained IOP rise Ocular hypertension requiring treatment occurred in 3 eyes. None of these eyes had progressive disc changes or visual field defects suggestive of glaucoma and all had well controlled IOP on topical, single drug therapy. Overall, there was a small, insignificant rise in IOP after DALK (p = 0.11). CONCLUSIONS: The long term risk of glaucoma following DALK using the manual dissection technique appears to be low. Ocular hypertension after DALK is infrequent and can be controlled on topical medication alone.
Department of Ophthalmology, St James's University Hospital, Leeds, UK.
Full articleClassification:
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)
