The Incidence and Risk Factors of Post-Penetrating Keratoplasty Glaucoma
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Abstract
Purpose: To evaluate the incidence and significant risk factors of glaucoma after penetrating keratoplasty (PK) operation.
Methods: A retrospective study of 62 eyes of 61 patients who underwent penetrating keratoplasty from January 2020 to December 2022 in Thammasat University Hospital, Thailand, was carried out. Age, sex, preoperative diagnosis, the presence of preoperative glaucoma, recipient graft size, the status of the lenses, and additional surgery performed during keratoplasty, which may affect the postoperative intraocular pressure, were evaluated.
Results: The overall incidence of post-penetrating keratoplasty glaucoma (PPKG) was 37.1%. The patients’ ages ranged from 20 to 95 years (with a mean of 63.53 ± 15.58 years). Twenty-nine patients (47.54%) were male. Preoperative diagnosis of inflammatory diseases such as corneal perforation (relative risk [RR] = 2.95), keratitis on graft (RR = 2.18), trauma (RR = 1.38), and infectious keratitis (RR = 1.24) were found to be risk factors for the development of glaucoma. Other significant risk factors included recipient size ³ 8mm, peripheral anterior synechiae (PAS) or shallow anterior chamber (AC), and pre-existing glaucoma (p = 0.03, 0.001, and 0.002 respectively). The average period to develop glaucoma after PK was 3.77 ± 4.81 months.
Conclusion: IOP monitoring should be started in the early postoperative period and as a routine in follow-up period especially in patients presenting significant risk factors such as large recipient graft, pre-operative peripheral anterior synechia formation, and pre-existing glaucoma.. Patient with glaucoma history should be carefully evaluated both pre- and post-operatively in PK operation.
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