Surgical management of patients with combined glaucoma and corneal transplant surgery.

The reasons for having combined glaucoma and corneal transplant surgery are myriad. Patients with corneal transplants have a high frequency of developing secondary glaucoma. Patients with preexisting glaucoma have even higher risk for developing glaucoma refractory to medical management after penetrating keratoplasty. The indication for corneal transplant affects the risk for developing postkeratoplasty glaucoma. The surgical treatment options for treating glaucoma include laser trabeculoplasty, cycloablation, trabeculectomy, and glaucoma drainage implants. In addition, the sequencing of glaucoma surgery relative to penetrating keratoplasty affects the outcome. Newer corneal transplant techniques may have a lower risk for developing secondary glaucoma.