What are the risk factors for 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

Simply put, the important risk factors for glaucoma in patients undergoing PKP include lens status (aphakic, phakic), preexisting glaucoma, and the disease for which PKP was performed. [12]

Penetrating keratoplasty is performed to treat corneal dystrophies and keratoconus, bullous keratopathy, anterior segment trauma, iridocorneal endothelial syndrome, corneal perforations, mesodermal dysgenesis, and adherent leukoma, along with other diseases of smaller incidence. Penetrating keratoplasty may also be performed if previous PKP was unsuccessful or in combination with intracapsular cataract extraction or vitrectomy. [2, 8, 9, 13, 14, 15, 16, 17, 18]  

A 10-year retrospective cohort study of 1657 eyes identified the strongest risk factors for increased IOP requiring therapy after PKP to be preoperative glaucoma (or IOP > 20 mm Hg), postoperative aphakia, and intraocular lens removal or exchange associated with keratoplasty. [19]

When looking at the indication for PKP in particular, bullous keratopathy, trauma, herpes simplex infection, and bacterial corneal ulceration or perforations are associated with higher risk for PKPG than are keratoconus, stromal dystrophies, and Fuchs dystrophy. [5, 20, 21, 22, 23]


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