2M.D. Asistant, Bozyaka Training and Research Hospital, Eye Clinic, Izmir/TURKEY
3M.D. Associate Professor, Bozyaka Training and Research Hospital, Eye Clinic, Izmir/TURKEY Purpose: To investigate the incidence, occurrence period, progression and risk factors for intraocular pressure (IOP) elevation after Penetrating Keratoplasty (PK) as well as its management and treatment results.
Materials and Methods: Data of 342 eyes who had PK between 2003-2014 with a regular follow-up and IOP measurements of at least 1 year were reviewed retrospectively. 102 eyes with a rise in IOP exceeding 21 mmHg during follow-up were spared and analysed.
Results: IOP increase occurred in 29.8% of the patients. Mean time of occurrence was 16.8±13.3 (2-52) post-operative week. Mean age was 60.6±17.6 (14-83). Number of patients under age 40 was 30 (27.0%). Mean preoperative IOP of 14.6±2.9 (5-20) mmHg increased to 25.7±4.1 (22-45) mmHg. Combined procedures during PK had no significant effect on postoperative pressure elevation (p=0.076, Chi-square test). Age, gender and trephine diameters were not significant risk factors. However, pseudophakic bullous keratopathy with an incidence of 48.1% was found as the most significant risk factor (p=0.002, Ki-kare testi). IOP was controlled with one topical agent in 44 eyes (43.1%), with fixed combination in 51 eyes (50.0%), in 6 eyes (5.9%) which were resistant to medical therapy trabeculectomy was performed in eye (1.0%) Ahmed Glaucoma Device was implanted.
Conclusion: IOP elevation is a serious complication after PK which is not rare. Especially pseudophakic bullous keratopathy is a significant risk factor. In order to protect graft clarity and optic disc functions, IOP should be monitored closely after PK and aggressively treated if found to be high.
Keywords : Penetrating keratoplasty, intraocular pressure, trabeculectomy