Management of Patients With Combined Glaucoma and Corneal Transplant Surgery

M Banitt; RK Lee

Disclosures

Eye. 2009;23(10):1972–1979 

In This Article

Abstract and Introduction

Abstract

Penetrating keratoplasty (PKP) is associated with an increased risk of secondary glaucoma. The development of glaucoma after PKP is an important risk factor for decreased corneal graft survival. The incidence of glaucoma after corneal transplant as well as the mechanism of developing increased intraocular pressure is reviewed in this paper. Treatments for post-PKP glaucoma include medications, laser, and surgery. The most frequent surgical glaucoma intervention is implantation of a glaucoma-drainage device. Recent advances in corneal transplantation surgery may help to decrease corneal failure and the risk of developing post-keratoplasty glaucoma.

Introduction

Advances in keratoplasty surgical techniques may help to decrease the incidence of secondary glaucoma after keratoplasty surgery. The development of glaucoma after penetrating keratoplasty (PKP) can lead to devastating long-term complications, which are often sight threatening and challenging to treat. Patients with glaucoma after corneal transplants often respond poorly to medications and laser treatment and require surgical intervention not only to lower the intraocular pressure and preserve the optic nerve, but also to improve the survival of the corneal graft. This paper reviews the incidence, mechanism, and treatment of secondary glaucoma associated with corneal transplantation. Current trends in corneal transplantation and glaucoma surgery are also discussed.

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