Posters

Incidence and risk factors of ocular hypertension/glaucoma after descemet’s stripping automated endothelial keratoplasty

Poster Details

First Author: S.Maqsood UK

Co Author(s):    D. Lueng   D. Lake   S. Hamada   M. Elalfy           

Abstract Details

Purpose:

To evaluate the incidence, demographics, associated risk factors, management and clinical outcomes of ocular hypertension/glaucoma after Descemet stripping automated endothelial keratoplasty (DSAEK).

Setting:

Queen Victoria Hospital

Methods:

We reviewed data from the case records of 120 DSAEK cases performed at Queen Victoria Hospital, UK, from 2009 to 2013. Patient with pre-existing glaucoma, transient increased IOP within the first 48hours post-graft, additional post-transplant surgery, or failed to complete one year follow up were excluded from the study. Ocular hypertension was defined as intraocular pressure (IOP) elevation >21mmHg or ≥ 6mmHg from baseline at any postoperative visit.

Results:

The incidence of post-DSAEK ocular hypertension and glaucoma was 51.9% and 13.6% respectively. Steroid-induced IOP elevation was the most frequent cause, with an incidence of 38.3%. Risk factors such as pseudophakia (p=0.024) and preoperative IOP>16 (p=0.003) were found to be associated with post-DSAEK ocular hypertension. Preoperative IOP>16 had 5.27 times risk of IOP elevation. Eyes with graft dislocation and/or detachment were significantly associated with post-DSAEK glaucoma (p=0.038). In all cases, IOP elevation was treated effectively by switching the type of steroid eye drops, tapering their frequency, and/or the use of anti-glaucoma medication. There was no negative effect of OHT on visual acuity and graft status.

Conclusions:

Glaucoma and OHT are common postoperative complications of DSAEK. Although steroid-induced IOP elevation was the most frequent cause, there are other reasons associated with development of post-DSAEK glaucoma, including graft dislocation and detachment. Eyes with preoperative IOP>16 may require a close monitoring of IOP. In addition, management by medical treatment results in good visual acuity and graft clarity

Financial Disclosure:

None