Post-keratoplasty glaucoma in perforated fungal keratitis
Session Details
Session Title: Glaucoma Management
Session Date/Time: Monday 16/09/2019 | 16:30-18:00
Paper Time: 17:00
Venue: Free Paper Forum: Podium 4
First Author: : C.Kalamkar INDIA
Co Author(s): : A. Mukherjee R. Rao
Abstract Details
Purpose:
To report our experience in management of post penetrating keratoplasty glaucoma where therapeutic keratoplasty was done for perforated fungal keratitis.
Setting:
Tertiary care institute in Central India
Methods:
This was a retrospective study of 76 eyes (76 patients) that had undergone therapeutic penetrating keratoplasty (TPK ) for perforated fungal keratitis from January 2015 till December 2016 in a tertiary eye care center in central India. Minimum follow-up period was 1 year. Indication of starting topical anti-glaucoma medication (AGM) was intraocular pressure (IOP) of 21 mm Hg or more. Uncontrolled IOP on 3 medications was considered as an indication for trabeculectomy. Ahmed Glaucoma Valve implant (AGV) was done in failed Trabeculectomy cases.
Results:
Out of 76 eyes, 51 (67%) developed glaucoma during the follow-up period. Medical management was successful in 11 eyes (21. 6%).40 eyes underwent trabeculectomy out of which 12 eyes ( 23.5%) required AGV implantation.42 % eyes with AGV developed graft failure while 18 % eyes , which had undergone only trabeculectomy, had graft failure. 1 eye had graft rejection after AGV
Incidence of PTKG is high in cases with perforated corneal ulcers due to presence of widePASwith secondary angle closure. Other factors in our study were concomitant anterior vitrectomy and lens extraction with PK. Majority of eyes required surgical management.
Conclusions:
Post keratoplasty glaucoma in perforated fungal keratitis is a major cause of vision loss due to graft failure. Higher incidence of PTKG in these patients entails regular IOP monitoring in all such cases. Failure of medical management is high with more cases requiring surgical intervention.
Financial Disclosure:
None
