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N. Ozeki, K. Yuki, D. Shiba, S. Shimmura, M. Dogru, K. Tsubota; Glaucoma After Descemet's Stripping Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2201.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma after penetrating keratoplasty is not rare. However glaucoma after Descemet’s stripping endothelial keratoplasty (DSEK) has not been reported until now. In this study, we investigated the incidence of glaucoma after DSEK and associated clinical findings.
A retrospective study was carried out in 48 eyes of 47 patients who underwent DSEK from May 2006 to August 2008. The development of postkeratoplasty glaucoma was defined as an increase of intraocular pressure above 21 mmHg lasting at least 2 months, in whom the use of steroids was discontinued for at least 2 months, and who required the introduction of antiglaucoma therapy(medical or surgical). This definition excludes patients with preexisting glaucoma. The incidence of glaucoma after DSEK was evaluated in this study.
Nine eyes of 8 male patients and 34 eyes of 34 female patients were studied. Five patients who had preexisting glaucoma were excluded. The patients’ ages ranged between 55 and 90 years, with an average of 73.7 ± 8.6. Follow up time ranged from 2 to 30 months (mean, 11.9 ± 8.6months). Of the 43 eyes, 16 had bullous keratopathy (BK) after laser iridotomy (LI), 8 had fuchs dystrophy, 8 had pseudophakic BK, 2 had corneal endotheliitis, 2 had ICE syndrome and in 7 the etiology was unknown. After DSEK, glaucoma therapy became necessary in 6 eyes (12.5%) of 6 patients, out of whom 3 were treated with medical management and 3 required surgical intervention. The age of the 6 patients ranged from 64 to 84 (mean, 76.2 ± 6.6years). There was no difference in the age between postoperative glaucoma and not having glaucoma (P=0.47). We diagnosed glaucoma from 2 to 9 months (mean, 4.7 ± 2.6months) after DSEK. Of the 6 eyes, 3 had BK after LI, 2 had pseudophakic BK, and the etiology was unknown in one eye. There was no difference in the incidence of glaucoma between BK after LI and pseudophakic BK (P=0.55).
The incidence of glaucoma after DSEK was 12.5%. This study demonstrated that glaucoma was one of the common postoperative complications of DSEK. The incidence of glaucoma between BK after LI and pseudophakic BK did not show marked differences.
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