Intraocular pressure after homologous penetrating keratoplasty.
OBJECTIVE
To evaluate intraocular pressure (IOP) changes after homologous central penetrating keratoplasty in a noncomparative interventional case series.


METHODS
The study included 245 patients undergoing homologous central penetrating keratoplasty for keratoconus (n = 77), herpetic corneal scars (n = 29), nonherpetic corneal scars (n = 46), Fuchs endothelial dystrophy (n = 24), and secondary corneal endothelial decompensation caused by preceding intraocular operations (n = 69). Mean follow-up time was 30.4 +/- 18.7 months (range, 12.1-111.6 months). The same surgeon operated on all patients, and a peripheral iridotomy was routinely performed.


RESULTS
On the first postoperative day, IOP was significantly (P = 0.02) higher than that before keratoplasty. Taking the whole study group and taking the study groups separately, IOP measurements determined on the third postoperative day (P = 0.57), 1 week after surgery (P = 0.55), or later (P > 0.50) were not significantly different from the preoperative values. Eyes undergoing keratoplasty with cataract surgery and eyes undergoing keratoplasty without additional intraocular procedures did not vary significantly (P > 0.10) in IOP measurements. IOP did not differ significantly (P > 0.50) between eyes with an immunologic graft reaction (n = 29) and eyes without a reaction (n = 216). Acute angle-closure glaucoma was not detected in any of the patients. IOP measurements were statistically independent of suture type (P > 0.10), age (P > 0.05), preoperative and postoperative refractive error (P > 0.05), preoperative and postoperative corneal astigmatism (P > 0.10), preoperative and postoperative visual acuity (P > 0.10), diameter of graft and trephine (P > 0.15), and oversize of the graft (P > 0.50). Postoperative IOP measurements were significantly (P < 0.01) correlated with preoperative IOP values.


CONCLUSIONS
In eyes with a peripheral iridotomy performed during surgery, homologous central penetrating keratoplasty usually does not markedly change IOP. The main risk factor for postoperatively increased IOP is increased IOP before surgery.
Jonas
J B
JB
Department of Ophthalmology and Eye Hospital, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
Rank
R M
RM
Hayler
J K
JK
Budde
W M
WM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D003316:Corneal Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D014065:Tonometry, Ocular