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Escalation of glaucoma therapy after penetrating keratoplasty and Descemet’s stripping automated endothelial keratoplasty for pseudophakic bullous keratopathy

Poster Details

First Author: S.Alswailem SAUDI ARABIA

Co Author(s):    W. Alsakran   S. Alshahwan                 

Abstract Details


to compare the prevalence and risk factors of glaucoma therapy escalation (GTE) after penetrating keratoplasty (PKP) and Descemet’s stripping automated endothelial keratoplasty (DSAEK), and its impact on graft survival and visual outcome.


175 consecutive eyes of patients undergoing PKP and DSAEK at the King Khaled Eye Specialist Hospital


A retrospective review of the medical records of all patients who underwent keratoplsty to treat pseudophakic corneal edema at a tertiary eye care center, between 2009 and 2014 and who completed a minimum follow-up of 12 months.


GTE occurred in 27 (46.5%) of 58 eyes after PKP and in 40 (34.2%) of 117 eyes after DSAEK at a mean follow-up of 33.1 and 33.3 months, respectively. The prevalence of preoperative glaucoma was similar between both groups (24% vs 20% respectively; P=0.268). Pre-operative glaucoma was highly associated with GTE in DSAEK (P<0.001) and not with PKP group. The mean value of intraocular pressure was higher in DSAEK group in the first 6 months, but became less at most recent visit. Graft failure occurred in 73.3% (P=0.001) after PKP and in 85.0% (P<0.001) after DSEK in eyes with GTE.


Glaucoma therapy escalation is relatively common and occurs with comparable frequency in eyes with pseudophakic corneal edema after PKP and DSAEK. Close monitoring of IOP is warranted after keratoplasty. GET is significantly associated with an increased risk of graft failure and poor visual outcome.

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