Postkeratoplasty glaucoma (PKG) is one of the challenging issues that may compromise the graft.
The aim of this work was to study the incidence of glaucoma following penetrating keratoplasty (PKP) in pseudophakic or aphakic eyes and in cataractous eyes following combined PKP and cataract surgery and to highlight the risk factors involved in this complication.
This is a prospective interventional nonrandomized study.
This study was conducted in the outpatient ophthalmology clinic of Kasr El-Aini Cairo University Hospitals between January 2011 and January 2013.
Patients and methods
Fifty-eight pseudophakic or aphakic eyes requiring PKP (group I) and 34 cataractous eyes that required combined PKP and cataract surgery (group II) were enrolled.
The primary outcome measure was the change in intraocular pressure (IOP) using a tonopen. The Secondary outcome measures were the results of graft survival and the best corrected visual acuity.
The procedure adopted, whether PKP or combined PKP and cataract, significantly influenced the occurrence of PKG (P=0.003, using the &khgr;2-test). In addition, the aetiology for PKP was a statistically significant factor (P<0.001). As regards postoperative graft survival, PKG was found to be a statistically significant risk factor (P<0.001, using the &khgr;2-test).
Conclusion and relevance
The incidence of glaucoma following PKP in pseudophakic eyes was 72.4%, whereas its incidence following combined PKP and cataract surgery was 41.2%, which was a significant difference. Eyes with buphthalmos had the highest incidence of PKG (100%), whereas eyes that had experienced preoperative trauma had the least incidence (25%), which was significant. PKG was found to be a significant risk factor for graft survival (P<0.001), with 35.7% of the eyes that developed postoperative glaucoma experiencing graft failure.