Skip to main content

Advertisement

SpringerLink
Log in

Glaucoma therapy escalation in eyes with pseudophakic corneal edema after penetrating keratoplasty and Descemet’s stripping automated endothelial keratoplasty

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

The purpose of this study was to determine and compare the prevalence of glaucoma therapy escalation (GTE) after penetrating keratoplasty (PKP) and Descemet’s stripping automated endothelial keratoplasty (DSAEK) in eyes with a surgical indication of pseudophakic corneal edema. A retrospective review was conducted of the medical records of all patients who underwent PKP or DSAEK to treat pseudophakic corneal edema at a tertiary eye care center from January 1 2003 to December 31, 2006. Eyes that were treated with PKP from January 1, 2003 to December 31, 2004 and with DSAEK from January 1, 2005 to December 31, 2006 were included in the statistical analysis. Inclusion criteria included satisfactory preoperative control of intraocular pressure (IOP) and follow-up of at least 12 months. The main outcome measure was GTE, which was defined as a sustained requirement for escalation of topical medical therapy or the need to provide surgical intervention to maintain a satisfactory postoperative IOP. Among 54 eyes that met the inclusion criteria, GTE occurred in 7 (35.0%) of 20 eyes after PKP and in 14 (41.2%) of 34 eyes after DSAEK (P = 0.78) during a mean follow-up period of 27.6 and 28.6 months, respectively. Surgical escalation occurred in 2 (10.0%) eyes after PKP and 2 (5.9%) eyes after DSAEK (P = 0.62), and was associated with late-onset endothelial graft failure in all four eyes. Glaucoma therapy escalation is relatively common and occurs with comparable frequency in eyes with pseudophakic corneal edema after PKP and DSAEK.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Greenlee EC, Kwon YH (2008) Graft failure: III. Glaucoma escalation after penetrating keratoplasty. Int Ophthalmol 28:191–2007

    Article  PubMed  Google Scholar 

  2. Thoft RA, Gordon JM, Dohlman CH (1974) Glaucoma following keratoplasty. Trans Am Acad Ophthalmol Otolaryngol 78:OP352–OP364

    PubMed  CAS  Google Scholar 

  3. Goldberg DB, Schanzlin DJ, Brown SI (1981) Incidence of increased intraocular pressure after keratoplasty. Am J Ophthalmol 92:372–377

    PubMed  CAS  Google Scholar 

  4. Simmons RB, Stern RA, Teekhasaenee C, Kenyon KR (1989) Elevated intraocular pressure following penetrating keratoplasty. Trans Am Ophthalmol Soc 87:79–91

    PubMed  CAS  Google Scholar 

  5. Ayyala RS (2000) Penetrating keratoplasty and glaucoma. Surv Ophthalmol 45:91–105

    Article  PubMed  CAS  Google Scholar 

  6. Franca ET, Arcieri ES, Arcieri R, Rocha FJ (2002) A study of glaucoma after penetrating keratoplasty. Cornea 21:284–288

    Article  PubMed  Google Scholar 

  7. Chien AM, Schmidt CM, Cohen EJ et al (1993) Glaucoma in the immediate postoperative period after penetrating keratoplasty. Am J Ophthalmol 115:711–714

    PubMed  CAS  Google Scholar 

  8. Becker B, Mills DW (1963) Corticosteroids and intraocular pressure. Arch Ophthalmol 70:500–507

    Article  PubMed  CAS  Google Scholar 

  9. Armaly MF (1967) Inheritance of dexamethasone hypertension and glaucoma. Arch Ophthalmol 77:747–751

    Article  PubMed  CAS  Google Scholar 

  10. Spaeth GL, Rodrigues MM, Weinreb S (1977) Steroid-induced glaucoma: a. persistent elevation of intraocular pressure B. Histopathological aspects. Trans Am Ophthalmol Soc 75:353–381

    PubMed  CAS  Google Scholar 

  11. Olson RJ, Kaufman HE (1977) A mathematical description of causative factors and prevention of elevated intraocular pressure after keratoplasty. Invest Ophthalmol Vis Sci 16:1085–1092

    PubMed  CAS  Google Scholar 

  12. Zimmerman TJ, Krupin T, Grodski W, Waltman SR (1978) The effect of suture depth on outflow facility in penetrating keratoplasty. Arch Ophthalmol 96:505–506

    Article  PubMed  CAS  Google Scholar 

  13. Zimmerman T, Olson R, Waltman S, Kaufman H (1978) Transplant size and elevated intraocular pressure. Postkeratoplasty. Arch Ophthalmol 96:2231–2233

    Article  PubMed  CAS  Google Scholar 

  14. Foulks GN, Perry HD, Dohlman CH (1979) Oversize corneal donor grafts in penetrating keratoplasty. Ophthalmology 86:490–493

    PubMed  CAS  Google Scholar 

  15. Olson RJ (1978) Aphakic keratoplasty. Determining donor tissue size to avoid elevated intraocular pressure. Arch Ophthalmol 96:2274–2276

    Article  PubMed  CAS  Google Scholar 

  16. Bourne WM, Davison JA, O’Fallon WM (1982) The effects of oversize donor buttons on postoperative intraocular pressure and corneal curvature in aphakic penetrating keratoplasty. Ophthalmology 89:242–246

    PubMed  CAS  Google Scholar 

  17. Karesh JW, Nirankari VS (1983) Factors associated with glaucoma after penetrating keratoplasty. Am J Ophthalmol 96:160–164

    PubMed  CAS  Google Scholar 

  18. Kirkness CM, Ficker LA (1992) Risk factors for the development of postkeratoplasty glaucoma. Cornea 11:427–432

    Article  PubMed  CAS  Google Scholar 

  19. Sihota R, Sharma N, Panda A et al (1998) Post-penetrating keratoplasty glaucoma: risk factors, management, and visual outcome. Aust N Z J Ophthalmol 26:305–309

    Article  PubMed  CAS  Google Scholar 

  20. Al-Mohaimeed M, Al-Shahwan S, Al-Torbak A, Wagoner MD (2007) Escalation of glaucoma therapy after penetrating keratoplasty. Ophthalmology 114:2281–2286

    Article  PubMed  Google Scholar 

  21. Goins KM (2008) Surgical alternatives to penetrating keratoplasty II: endothelial keratoplasty. Int Ophthalmol 28:233–246

    Article  PubMed  Google Scholar 

  22. Wandling GR, Parikh M, Robinson C et al (2010) Escalation of glaucoma therapy after deep lamellar endothelial keratoplasty. Cornea 29:991–995

    Article  PubMed  Google Scholar 

  23. Burstein NL (1980) Corneal cytotoxicity of topically applied drugs, vehicles, and preservatives. Surv Ophthalmol 25:15–30

    Article  PubMed  CAS  Google Scholar 

  24. Sherwood MB, Grierson I, Millar L, Hitchings RA (1989) Long-term morphologic effects of anti-glaucoma drugs on the conjunctiva and Tenon’s capsule in glaucomatous patients. Ophthalmology 96:327–335

    PubMed  CAS  Google Scholar 

  25. Baudouin C, Pisella PJ, Fillacier K et al (1999) Ocular surface inflammatory changes induced by topical anti-glaucoma drugs: human and animal studies. Ophthalmology 106:556–563

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

None of the authors have any financial/conflicting interests to disclose.

Author information

Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA, USA

    George R. Wandling Jr., Matthew P. Rauen, Kenneth M. Goins, Anna S. Kitzmann, John E. Sutphin, Young H. Kwon, Wallace L. M. Alward & Michael D. Wagoner

  2. Department of Ophthalmology, Kansas University Medical Center, Kansas City, KS, USA

    John E. Sutphin

  3. Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Pomerantz Family Pavilion, 200 Hawkins Drive, Iowa City, IA, 52242-1091, USA

    Michael D. Wagoner

Authors
  1. George R. Wandling Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew P. Rauen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kenneth M. Goins
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna S. Kitzmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John E. Sutphin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Young H. Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wallace L. M. Alward
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michael D. Wagoner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael D. Wagoner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wandling, G.R., Rauen, M.P., Goins, K.M. et al. Glaucoma therapy escalation in eyes with pseudophakic corneal edema after penetrating keratoplasty and Descemet’s stripping automated endothelial keratoplasty. Int Ophthalmol 32, 9–14 (2012). https://doi.org/10.1007/s10792-011-9512-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-011-9512-2

Keywords

Search

Navigation