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Abstract #9251 Published in IGR 5-2
Incidence and factors influencing glaucoma after penetrating keratoplasty
Allouch C; Borderie V; Touzeau O; Scheer S; Nordmann JP; Laroche LJournal Français d'Ophtalmologie 2003; 26: 553-561
PURPOSE: To determine the incidence and factors influencing glaucoma following penetrating keratoplasty. MATERIAL AND METHODS: The authors prospectively studied 440 consecutive patients undergoing penetrating keratoplasty over a period of five years, with an average follow-up of two years. High intraocular pressure (IOP) was defined as over 20 mmHg measured by Goldmann applanation for at least one week, or if a patient required topical treatment for at least one week. Before surgery, 18.7% of the patients presented with glaucoma or high IOP; 44.9% received a graft for a bullous keratopathy condition, 25.6% had keratoconus, 31.5% received an anterior chamber lens, and 48.5% were phakic. RESULTS: After surgery, 42.2% of the patients had an IOP of 20 mmHg or higher and required treatment for high ocular pressure. The increase in IOP appeared after an average delay of 33.3 ± 4.7 months. The frequency of the increase in IOP was 54.3% for the bullous keratopathy, and 26.6% for the keratoconus patients (p < 0.001). At the end of the second year, graft survival was 82.1% in the absence of glaucoma, while it was 71.5% in cases of glaucoma after keratoplasty. Of all the parameters studied, high IOP before surgery, etiology, status, and receiver age over 60 years, were the main factors influencing high IOP after keratoplasty. IOP was correlated with a decrease in endothelial cell density and was at the origin of graft failure. IOP correlated with best spectacle corrected visual acuity (BSCVA) by its effect on endothelial cell density and optic nerve destruction. CONCLUSIONS: The increase in IOP is a real and serious complication of keratoplasty. Its physiopathology is very complex. Better knowledge of risk factors can be useful in controlling it. LA: French
Dr. C. Allouch, Pôle Hospitalo-Universitaire Saint-Antoine, CHNO des Quinze-Vingts, Service d'Ophtalmologie, 28 rue de Charenton, 75012 Paris, France
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)
