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Intraocular pressure changes following Descemet’s stripping with endothelial keratoplasty

  • Cornea
  • Published:
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Abstract

Purpose

To evaluate the postoperative changes in intraocular pressure (IOP) following Descemet’s stripping with endothelial keratoplasty (DSEK).

Methods

A retrospective chart review of 45 eyes that underwent DSEK for the treatment of corneal edema induced by aphakic or pseudophakic bullous keratopathy (ABK/PBK) and Fuchs’ endothelial dystrophy. A mean baseline IOP was obtained at three different preoperative visits using Tono-Pen® XL tonometer. This baseline pressure was compared to IOPs obtained at postoperative months 1, 3, 6 and 12.

Results

Intraocular pressure increased from a mean preoperative value of 15.6 ± 4.2 mmHg to 15.9 ± 5.8 mmHg in the first postoperative month; 17.0 ± 5.7 mmHg at 3 months; 18.1 ± 6.2 mmHg at 6 months and 16.8 ± 4.7 mmHg at 1 year. These pressure differences were considered statistically significant, p = 0.0074 (repeated measures ANOVA). Eyes diagnosed with ABK/PBK (n = 20) showed a significant rise in IOP only noted after the 3rd month that peaked at 6 months, p = 0.0001 (repeated measures ANOVA). A subgroup of patients with a diagnosis of Fuchs’ endothelial dystrophy (n = 25), showed no statistically significant changes in IOP at 1 year follow-up; p = 0.9103 (repeated measures ANOVA). In a subgroup of eyes with a diagnosis of glaucoma or ocular hypertension (n = 13), a statistically significant increase in IOP was noted after 1 year of follow-up. Mean IOP raised from a preoperative mean value of 16.0 ± 3.7 mHg to 19.0 ± 5.3 mmHg at 1 year; p = 0.0074 (repeated measures ANOVA).

Conclusions

DSEK induced statistically significant IOP increases in the early postoperative period with a tendency to higher pressures after the 3rd month of follow-up. Patients with a preoperative diagnosis of Fuchs’ endothelial dystrophy did not show a statistically significant increase in IOP compared to a baseline mean preoperative value. The difference between statistically significant and clinically significant IOP increase is yet to be established.

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Authors and Affiliations

  1. Corneal and External Diseases Service, Department of Ophthalmology, The University of Mississippi Medical Center, Jackson, MS, USA

    Edgar M. Espana, Zachary M. Robertson & Bo Huang

  2. The University of Mississippi Medical Center, Jackson, MS, 39216, USA

    Bo Huang

Authors
  1. Edgar M. Espana
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  2. Zachary M. Robertson
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  3. Bo Huang
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Correspondence to Bo Huang.

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Espana, E.M., Robertson, Z.M. & Huang, B. Intraocular pressure changes following Descemet’s stripping with endothelial keratoplasty. Graefes Arch Clin Exp Ophthalmol 248, 237–242 (2010). https://doi.org/10.1007/s00417-009-1199-y

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  • DOI: https://doi.org/10.1007/s00417-009-1199-y

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