[Corneal transplantation and glaucoma].

BACKGROUND

Recent studies have shown that increased intraocular pressure following keratoplasty may cause progressive endothelial cell loss and thereby lead to early transplant failure. This study examined risk groups for development of postoperative glaucoma and thereby transplant failure.

MATERIAL AND

METHODS

Seventy-five patients with various diagnoses were followed up prospectively for 2, 4, 6, 12, 24, 36, 48, and 60 months.

RESULTS

Of the 75 patients 22 showed elevated intraocular pressure after keratoplasty. One-third of these (n = 7) developed a chronic secondary glaucoma. The main risk factor was a preexisting glaucoma (P < 0.05, c2 test), followed by aphakia, especially if aphakia was present before keratoplasty. Three of the six patients with anterior synechia had increased intraocular pressure. Because of the small number of patients neither factors reached statistical significance.

CONCLUSION

Intraocular pressure should be closely monitored especially in high-risk patients, although its measurement may not be exact by Schiötz and Goldmann tonometry. Digital impression and controls of the visual field should be carried out additionally.