Post Penetrating Keratoplasty Glaucoma

2015 
Aim: To study of incidence, etiological factors contributing to secondary glaucoma following Penetrating Keratoplasty (PK). Materials and methods: It was a prospective study carried out at tertiary eye care centre for period of 2 years. Inclusion criteria: All the patients who were operated for optical penetrating keratoplasty & not having pre existing glaucoma. Exclusion criteria: primary graft failure, early post PK glaucoma, intraoperaticve complications, repeats PK. In all the patients, every standard pre-operative, operative, post-operative management were done. Results: Out of 98 patients, the most common age group of 30-45 years include 33(33.67%) patients, males (69, 70.41%) were more than females (29, 29.59%).The UBM was done in 50 patients-suggestive of 16(32%) had PAS(Peripheral Anterior Synechia); 18(36%) had adherent leucoma;28(56%) had phakic, 13(26%) had PCIOL;3(6%) had ACIOL; 6(12%) had aphakia. The 70(71.43%) were done PK, while 28(28.57%) were done triple surgery (PK, Cataract removal, IOL implantation). The post PK glaucoma was developed in 11 (11.2%) patients by the end of 3 rd month, while 24(24.4%) patients by end of 6 th month postoperatively. Out of 24 patients, 20(83.4%) were treated medically, 3(12.5%) surgically while cyclocryo was done in 1(4.1%) patient. The preoperative risk factors- ACIOL, Aphakia, PAS were found statistically significantly associated with post PK glaucoma with P-value -0.01333,0.04666,0.005 respectively. Conclusions: The post PK glaucoma was more common in 15-45 years of age, with more common in male. The high risk factors includes-PAS(32%), Graft rejection(14.4%), Graft failure(27.6%),Adherent leucoma(33%),ACIOL, Aphakia, Triple surgery, Graft size >8mm.the UBM aids in indentifying risk factors & thus in pre operative evaluation, surgical planning & prognostication.
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