What is the prevalence of penetrating keratoplasty and glaucoma (PKPG)?

Updated: Dec 30, 2020
  • Author: Shibandri Das, MD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Answer

In 1969, Irvine and Kaufman [9]  were the first to describe the high incidence of increased IOP after PKP. They reported a mean maximum pressure of 24 mm Hg in the first postoperative week, 40 mm Hg in patients with aphakia who had transplants, and 50 mm Hg in patients who had transplants combined with cataract extraction in the immediate postoperative period. [9]  Since then, numerous authors have reported on the incidence and management of PKPG.

The incidence of PKPG is approximately 9 to 50% and ranges from 9 to 13% in the early postoperative period (first few weeks after surgery) and from 18 to 35% in the late postoperative period (several weeks to months after surgery). [5, 10, 11]  This variation in incidence results from the differing definitions of glaucoma across studies. The mean time interval from PKP to diagnosis of PKPG is 24 weeks. [8]  Because the changes in the optic nerve or retinal nerve fiber layer are hard to track consistently across studies, these studies often use a threshold of intraoperative pressure (> 21 mm Hg) to define a diagnosis of glaucoma. [2]  Although the definition of glaucoma according to IOP is practical, we recognize that it is scientifically deficient as reflected by the large range in incidence of PKPG.


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