Glaucoma following keratoplasty

Background. Recent studies have shown that increased intraocular pressure f ollowing keratoplasty may cause progressive endothelial cell loss and there by lead to early transplant failure. This study examined risk groups for de velopment of postoperative glaucoma and thereby transplant failure. Material and methods. Seventy-five patients with various diagnoses were fol lowed up prospectively for 2, 4, 6, 12, 24, 36, 48, and 60 months. Results. Of the 75 patients 22 showed elevated intraocular pressure after k eratoplasty. One-third of these (n=7) developed a chronic secondary glaucom a. The main risk factor was a preexisting glaucoma (P<0.05, c(2) test), fol lowed by aphakia, especially if aphakia was present before keratoplasty. Th ree of the six patients with anterior synechia had increased intraocular pr essure. Because of the small number of patients neither factors reached sta tistical significance. Conclusion. Intraocular pressure should be closely monitored especially in high-risk patients, although its measurement may not be exact by Schiotz an d Goldmann tonometry. Digital impression and controls of the visual field s hould be carried out additionally.