Posters

Incidence and risk factors for secondary glaucoma after penetrating keratoplasty

Poster Details

First Author: M.Rajarajan INDIA

Co Author(s):    S. Mohan   M. Rajan   S. Archana              

Abstract Details

Purpose:

To analyze the incidence , associated risk factors , graft status and treatment modalities in patients with post penetrating keratoplasty glaucoma

Setting:

Rajan Eye Care Hospital Pvt Ltd

Methods:

Post Penetrating keratoplasty Glaucoma was defined as an elevated IOP (>21 mm Hg) following Penetrating Keratoplasty, with or without optic nerve damage and visual field changes. Penetrating keratoplasties were performed between Jan 1, 2011, and Dec 31, 2014 with a follow-up of 12 months were retrospectively analyzed. Indications for surgery, BCVA, Intraocular pressure ,graft size, fundus examination were noted. Clinical examination findings such as Best Corrected Visual Acuity; Slitlamp biomicroscopy; Intraocular pressure by Applanation Tonometry or Digital Tonometry, Gonioscopy, Fundus & disc findings were also observed. Statistical analysis paired and unpaired t-test. P value< 0.05 were considered significant.

Results:

Of 120 eyes, secondary glaucoma developed in 32 eyes. This yields an incidence of 26.7%. In cases of corneal ulcer the incidence of post-PK glaucoma was 43.8%; and in conditions like pseudophakic bullous keratopathy 31.3%,followed by 12.5% in aphakic bullous keratopathy,3.1% in corneal opacity and failed graft( P value 0.02). we observed that with graft size of 8 mm and above there was increased incidence of secondary glaucoma(36%) (P value0.01). 71.8% were managed by medical treatment, 28.1% underwent trabeculectomy with adjuvant Mitomycin C, of which 9.4% underwent combined procedure( phacoemulsification +trabeculectomy).

Conclusions:

Indications for Penetrating Keratoplasties was the most significant factor that predicts the development of glaucoma. Inflammed ,infected eyes and large grafts are more prone to develop glaucoma . Majority of them responded to medical management. However secondary glaucoma remains a challenge both with regards to diagnosis and treatment in post keratoplasty eyes.

Financial Disclosure:

None