title: Elevated Intraocular Pressure in Patients Undergoing Penetrating Keratoplasty and Descemet Stripping Endothelial Keratoplasty.
abstract: OBJECTIVE
  Our aim was to compare changes in intraocular pressure (IOP) and management of glaucoma in patients undergoing either penetrating keratoplasty (PK) or Descemet stripping endothelial keratoplasty (DSEK).
  
  
  METHODS
  A retrospective review of all patients who underwent primary corneal transplantation at Sydney Eye Hospital (Sydney, Australia) from January 2008 to December 2010 was performed. Eyes with comparable indications and either primary PK or DSEK with 12 months of follow-up were included. Data on IOP and antiglaucoma management postoperatively were collected. An IOP elevation of ≥30% from baseline or an absolute IOP of >24 at 1 year postoperatively was significant.
  
  
  RESULTS
  Sixty-one eyes from 61 patients met the inclusion criteria. Comparable eyes had undergone either PK (n=28, 46%) or DSEK (n=33, 54%). In patients without prior glaucoma (n=39), 29% of those in the PK group and 28% in the DSEK group required a change in therapy to control IOP (P=0.970). If there was prior glaucoma (n=22), the PK group required a change in 71% of patients compared with the DSEK group, 63% (P=0.665). In both groups of patients, PK and DSEK, elevation of IOP of at least 30% from baseline to 1 year was seen in 39% (P=0.993) regardless of glaucoma status.
  
  
  CONCLUSIONS
  Elevation of IOP is a serious consequence of both PK and DSEK, even despite maximal medical therapy in certain cases. DSEK has an equivalent incidence of IOP elevation to PK in comparable patients. Careful monitoring of IOP and appropriate therapy should be instituted to prevent progression to glaucoma.
authors.affiliation: Departments of *Sydney Eye Hospital †Save Sight Institute, Discipline of Ophthalmology, Sydney Eye Hospital Campus, The University of Sydney ‡National Health and Medical Research Council Clinical trials Centre, University of Sydney, Sydney, Australia.
authors.forename: Sartaj
authors.initials: S
authors.lastname: Sandhu
authors.forename: Constantinos
authors.initials: C
authors.lastname: Petsoglou
authors.forename: John
authors.initials: J
authors.lastname: Grigg
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Veillard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003316:Corneal Diseases / Q000601:surgery; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents