Incidence of Glaucoma After Repeat Penetrating Keratoplasty

Abstract

Abstract: : Purpose: To determine the incidence of glaucoma in patients who have had repeat penetrating keratoplasty (PK), and compare it to the incidence after initial PK. Methods: A retrospective chart review was conducted of 152 eyes that underwent PK from 1974 to 2002. Pre–operative and post–operative intraocular pressures (IOP), and medical and/or surgical interventions for increased IOP were recorded. Eyes that developed glaucoma after transplant were identified based on the following criteria: 1) IOP greater than 21 over two consecutive monthly follow–up visits, 2) initiation of medical treatment for elevated IOP, or 3) surgical intervention to reduce IOP. Incidence of glaucoma was determined for each eye after first PK and after each additional PK on the same eye. Results: The incidence of glaucoma after first PK (114 eyes) in all patients was 43.0%. The incidence of glaucoma in eyes that underwent a 2^nd transplant procedure (24 eyes) was 66.7%. The increase in incidence was statistically significant (p<0.05). In patients undergoing 3^rd, 4^th, and 5^th procedures (14 eyes), 92.9% developed glaucoma, an increase in incidence that was statistically significant (p<0.05). The incidence of glaucoma for all repeat procedures (38 eyes) was 76.3%. Conclusions: There was a higher incidence of glaucoma after repeat PK compared to initial PK. There was also a further increase in the risk of developing glaucoma after undergoing 3^rd, 4^th, or 5^th procedures as compared to 2^nd procedures. Analysis on more eyes will be carried out to better characterize the incidence of glaucoma after repeat PK.

Keywords: transplantation • clinical (human) or epidemiologic studies: prevalence/incidence • intraocular pressure