title: Anterior segment analysis and intraocular pressure elevation after penetrating keratoplasty and posterior lamellar endothelial keratoplasty.
abstract: BACKGROUND
  Peripheral anterior synechiae (PAS) is a common problem after penetrating keratoplasty (PK) and leads to intraocular pressure (IOP) elevation. This study examines the risk factors for IOP elevation and post-keratoplasty glaucoma.
  
  
  METHODS
  A retrospective analysis was performed of 47 eyes following PK and of 65 eyes following Descemet's stripping endothelial keratoplasty (DSEK) between 2009 and 2011. The assessment included preoperative history of corneal disease and glaucoma, response to treatment, IOP, and visual acuity. Irido-trabecular contacts (ITC), the angle opening distance (AOD 500) and the anterior chamber angle (ACA 500) were calculated.
  
  
  RESULTS
  The incidences of IOP elevation and post-keratoplasty glaucoma were 27-36% and 10-29%, respectively. The incidence did not differ significantly between both procedures. Pre-existing glaucoma increased the risk for developing IOP elevation and post-DSEK glaucoma. Eyes with bullous keratopathy (BK) developed significantly more IOP elevation (p = 0.01, d.f. = 1, χ(2) = 6.11) and post-keratoplasty glaucoma (p = 0.01, d.f. = 1, χ(2) = 6.22) than eyes with Fuchs' endothelial dystrophy. Eyes with ITC developed post-keratoplasty glaucoma significantly more often than eyes without ITC (p = 0.01, d.f. = 1, χ(2) = 6.63).
  
  
  CONCLUSIONS
  IOP elevation and post-keratoplasty glaucoma showed a high incidence. Risk factors like pre-existing glaucoma, BK and PAS elevated the rate of IOP elevation and post-keratoplasty glaucoma for both procedures.
authors.affiliation: Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Anna-Karina B
authors.initials: AK
authors.lastname: Maier
authors.forename: Enken
authors.initials: E
authors.lastname: Gundlach
authors.forename: Johannes
authors.initials: J
authors.lastname: Gonnermann
authors.forename: Matthias K J
authors.initials: MK
authors.lastname: Klamann
authors.forename: Christian
authors.initials: C
authors.lastname: Eulufi
authors.forename: Antonia M
authors.initials: AM
authors.lastname: Joussen
authors.forename: Eckart
authors.initials: E
authors.lastname: Bertelmann
authors.forename: Peter
authors.initials: P
authors.lastname: Rieck
authors.forename: Necip
authors.initials: N
authors.lastname: Torun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000473:pathology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001768:Blister / Q000601:surgery; D003316:Corneal Diseases / Q000601:surgery; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D005901:Glaucoma / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000502:physiology*; D015948:Keratoplasty, Penetrating; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents