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Abstract #19075 Published in IGR 3-1
Intraocular pressure after homologous penetrating keratoplasty
Jonas JB; Rank RM; Hayler JK; Budde WMJournal of Glaucoma 2001; 10: 32-37
PURPOSE: To evaluate intraocular pressure (IOP) changes after homologous central penetrating keratoplasty in a noncomparative interventional case series. METHODS: The study included 245 patients undergoing homologous central penetrating keratoplasty for keratoconus (n = 77), herpetic corneal scars (n = 29), nonherpetic corneal scars (n = 46), Fuchs endothelial dystrophy (n = 24), and secondary corneal endothelial decompensation caused by preceding intraocular operations (n = 69). Mean follow-up time was 30.4 ± 18.7 months (range, 12.1-111.6 months). The same surgeon operated on all patients, and a peripheral iridotomy was routinely performed. RESULTS: On the first postoperative day, IOP was significantly (p = 0.02) higher than that before keratoplasty. Taking the study group as a whole and the study groups separately, IOP measurements determined on the third postoperative day (p = 0.57), one week after surgery (p = 0.55), or later (p > 0.50) were not significantly different from the preoperative values. Eyes undergoing keratoplasty with cataract surgery and eyes undergoing keratoplasty without additional intraocular procedures did not vary significantly (P > 0.10) in IOP measurements. IOP did not differ significantly (P > 0.50) between eyes with an immunological graft reaction (n = 29) and eyes without a reaction (n = 216). Acute angle-closure glaucoma was not detected in any of the patients. IOP measurements were statistically independent of suture type (p > 0.10), age (p > 0.05), preoperative and postoperative refractive error (p > 0.05), preoperative and postoperative corneal astigmatism (p > 0.10), preoperative and postoperative visual acuity (p > 0.10), diameter of graft and trephine (p > 0.15), and oversize of the graft (p > 0.50). Postoperative IOP measurements were significantly (p < 0.01) correlated with preoperative IOP values. CONCLUSIONS: In eyes with a peripheral iridotomy performed during surgery, homologous central penetrating keratoplasty usually does not markedly change IOP. The main risk factor for postoperatively increased IOP is increased IOP before surgery.
Dr J.B. Jonas, Department of Ophthalmology and Eye Hospital, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
Classification:
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)
