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Intraocular pressure elevation after Descemet’s stripping endothelial keratoplasty

  • Clinical Investigation
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Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the incidence of intraocular pressure (IOP) elevation after Descemet’s stripping endothelial keratoplasty (DSEK) and associated clinical findings.

Methods

Forty-eight eyes of 46 patients who underwent DSEK were studied in this single-center retrospective study. IOP elevation was defined as the presence of an increase in IOP above 21 mmHg lasting at least two months, the need to introduce topical/oral antiglaucoma medications for at least two months, and the need for surgical therapy for uncontrolled IOP. Patients with pre-existing glaucoma or patients who were using antiglaucoma drugs before DSEK were excluded according to the protocol of the study. The incidence of post-DSEK IOP elevation was investigated.

Results

The incidence of IOP elevation after DSEK was 16.7 %. Glaucoma therapy following DSEK was needed in eight eyes of eight patients. IOP elevations were diagnosed from two to ten months after DSEK. There was no statistical difference in the survival probabilities of patients with different preoperative diagnoses. Pre-op IOP was observed to be a risk factor of IOP elevation in this series.

Conclusions

IOP elevation appears to be a common postoperative complication of DSEK. Patients without preexisting glaucoma but with higher pre-op IOP need to be followed up carefully after DSEK.

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References

  1. Price FW Jr, Price MO. Descemet’s stripping with endothelial keratoplasty in 50 eyes: a refractive neutral corneal transplant. J Refract Surg. 2005;21:339–45.

    PubMed  Google Scholar 

  2. Bahar I, Kaiserman I, Levinger E, Sansanayudh W, Slomovic AR, Rootman DS. Retrospective contralateral study comparing Descemet stripping automated endothelial keratoplasty with penetrating keratoplasty. Cornea. 2009;28:485–8.

    Article  PubMed  Google Scholar 

  3. Chen ES, Terry MA, Shamie N, Hoar KL, Friend DJ. Descemet-stripping automated endothelial keratoplasty: six-month results in a prospective study of 100 eyes. Cornea. 2008;27:514–20.

    Article  PubMed  Google Scholar 

  4. Gorovoy MS. Descemet-stripping automated endothelial keratoplasty. Cornea. 2006;25:886–9.

    Article  PubMed  Google Scholar 

  5. Koenig SB, Covert DJ, Dupps WJ Jr, Meisler DM. Visual acuity, refractive error, and endothelial cell density six months after Descemet stripping and automated endothelial keratoplasty (DSAEK). Cornea. 2007;26:670–4.

    Article  PubMed  Google Scholar 

  6. Koenig SB, Covert DJ. Early results of small-incision Descemet’s stripping and automated endothelial keratoplasty. Ophthalmology. 2007;114:221–6.

    Article  PubMed  Google Scholar 

  7. Mearza AA, Qureshi MA, Rostron CK. Experience and 12-month results of Descemet-stripping endothelial keratoplasty (DSEK) with a small-incision technique. Cornea. 2007;26:279–83.

    Article  PubMed  Google Scholar 

  8. Price FW Jr, Price MO. Descemet’s stripping with endothelial keratoplasty in 200 eyes: early challenges and techniques to enhance donor adherence. J Cataract Refract Surg. 2006;32:411–8.

    Article  PubMed  Google Scholar 

  9. Yuki K, Shimmura S, Shiba D, Tsubota K. Trabeculotomy for the treatment of glaucoma after Descemet stripping endothelial keratoplasty. Br J Ophthalmol. 2008;92:1299–300.

    Article  PubMed  CAS  Google Scholar 

  10. Vajaranant TS, Price MO, Price FW, Gao W, Wilensky JT, Edward DP. Visual acuity and intraocular pressure after Descemet’s stripping endothelial keratoplasty in eyes with and without preexisting glaucoma. Ophthalmology. 2009;116:1644–50.

    Article  PubMed  Google Scholar 

  11. Zimmerman TJ, Waltman SR, Sachs U, Kaufman HE. Intraocular pressure after aphakic penetrating keratoplasty “through-and-through” suturing. Ophthalmic Surg. 1979;10:49–52.

    PubMed  CAS  Google Scholar 

  12. Zimmerman TJ, Krupin T, Grodzki W, Waltman SR. The effect of suture depth on outflow facility in penetrating keratoplasty. Arch Ophthalmol. 1978;96:505–6.

    Article  PubMed  CAS  Google Scholar 

  13. Greenlee EC, Kwon YH. Graft failure: III. Glaucoma escalation after penetrating keratoplasty. Int Ophthalmol. 2008;28:191–207.

    Article  PubMed  Google Scholar 

  14. Al-Mohaimeed M, Al-Shahwan S, Al-Torbak A, Wagoner MD. Escalation of glaucoma therapy after penetrating keratoplasty. Ophthalmology. 2007;114:2281–6.

    Article  PubMed  Google Scholar 

  15. Franca ET, Arcieri ES, Arcieri RS, Rocha FJ. A study of glaucoma after penetrating keratoplasty. Cornea. 2002;21:284–8.

    Article  PubMed  Google Scholar 

  16. Patel SV, Hodge DO, Bourne WM. Corneal endothelium and postoperative outcomes 15 years after penetrating keratoplasty. Trans Am Ophthalmol Soc. 2004;102:57–65 (discussion 65–6).

    Google Scholar 

  17. Simmons RB, Stern RA, Teekhasaenee C, Kenyon KR. Elevated intraocular pressure following penetrating keratoplasty. Trans Am Ophthalmol Soc. 1989;87:79–91 (discussion 91–3).

    Google Scholar 

  18. Vajaranant TS, Price MO, Price FW, Wilensky JT, Edward DP. Intraocular pressure measurements following Descemet stripping endothelial keratoplasty. Am J Ophthalmol. 2008;145:780–6.

    Article  PubMed  Google Scholar 

  19. Mawatari Y, Kobayashi A, Yokogawa H, Sugiyama K. Intraocular pressure after Descemet’s stripping and non-Descemet’s stripping automated endothelial keratoplasty. Jpn J Ophthalmol. 2011;55:98–102.

    Article  PubMed  Google Scholar 

  20. Lass JH, Pavan-Langston D. Timolol therapy in secondary angle-closure glaucoma post penetrating keratoplasty. Ophthalmology. 1979;86:51–9.

    PubMed  CAS  Google Scholar 

  21. Ayyala RS. Penetrating keratoplasty and glaucoma. Surv Ophthalmol. 2000;45:91–105.

    Article  PubMed  CAS  Google Scholar 

  22. Foulks GN. Glaucoma associated with penetrating keratoplasty. Ophthalmology. 1987;94:871–4.

    PubMed  CAS  Google Scholar 

  23. Polack FM. Glaucoma in keratoplasty. Cornea. 1988;7:67–70.

    PubMed  CAS  Google Scholar 

  24. Kirkness CM, Moshegov C. Post-keratoplasty glaucoma. Eye. 1988;2(Suppl):S19–26.

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Naoki Ozeki.

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Ozeki, N., Yuki, K., Shiba, D. et al. Intraocular pressure elevation after Descemet’s stripping endothelial keratoplasty. Jpn J Ophthalmol 56, 307–311 (2012). https://doi.org/10.1007/s10384-012-0149-0

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  • DOI: https://doi.org/10.1007/s10384-012-0149-0

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