Glaucoma surgery after keratoplasty decreases IOP

The surgical management of glaucoma after different keratoplasty techniques effectively decreased intraocular pressure (IOP) and the number of glaucoma medications in patients who developed post-keratoplasty glaucoma, according to a study.

Fifty-five patients who developed post-keratoplasty glaucoma that could not be controlled with medical treatment and underwent glaucoma surgery were included in this study. Techniques included trabeculectomy, Ahmed glaucoma valve (AGV) implantation, or diode laser cyclophotocoagulation (DLC).

Amongst the 42 patients undergoing penetrating keratoplasty, DLC was applied to 30 (71.4%) eyes, AGV to 11 (26.2%) eyes, and trabeculectomy in 1 (2.4%) eye. In the 8 patients undergoing Descemet’s membrane endothelial keratoplasty, DLC was applied to 4 (50%) eyes, trabeculectomy for 3 (37.5%) eyes and AGV for 1 (12.5%) eye. In the 5 patients undergoing deep anterior lamellar keratoplasty, DLC was applied to 2 (40%) eyes, trabeculectomy to 2 (40%) eyes and AGV to 1 (20%) eye.

There was a statistically significant decrease in IOP and anti-glaucomatous medication after surgery but no significant difference in best corrected visual acuity (BCVA).

During the follow up period, DLC was performed as re-glaucoma surgery in 19 (34.5%) cases, resulting in a significant reduction in IOP and number of anti-glaucomatous medications but a significant decrease in BCVA.

Reference
Oztutuncu O, Altan C, Gumus G, et al. Surgical management of glaucoma following different keratoplasty techniques. Int Ophthalmol. 2022;doi: 10.1007/s10792-022-02273-x. Epub ahead of print. PMID: 35366139.