Intraocular pressure after homologous penetrating keratoplasty

Purpose: To evaluate intraocular pressure (IOP) changes after homologous ce ntral penetrating keratoplasty in a noncomparative interventional case seri es. Methods: The study included 245 patients undergoing homologous central pene trating keratoplasty for keratoconus (n = 77), herpetic corneal scars (n = 29), nonherpetic corneal scars (n = 46), Fuchs endothelial dystrophy (n = 2 4), and secondary corneal endothelial decompensation caused by preceding in traocular operations (n = 69). Mean follow-up time was 30.4 +/- 18.7 months (range, 12.1-111.6 months). The same surgeon operated on all patients, and a peripheral iridotomy was routinely performed. Results: On the first postoperative day, TOP was significantly (P = 0.02) h igher than that before keratoplasty. Taking the whole study group and takin g the study groups separately. IOP measurements determined on the third pos toperative day (P = 0.57), 1 week after surgery (P = 0.55), or later (P = 0 .50) were not significantly different from the preoperative values. Eyes un dergoing keratoplasty with cataract surgery and eyes undergoing keratoplast y without additional intraocular procedures did not vary significantly (P > 0.10) in IOP measurements. IOP did not differ significantly (P > 0.50) bet ween eyes with an immunologic graft reaction (n = 29) and eyes without a re action(n = 216). Acute angle-closure glaucoma was not detected in any of th e patients. IOP measurements were statistically independent of suture type (P > 0.10), age (P > 0.05), preoperative and postoperative refractive error (P > 0.05), preoperative and postoperative corneal astigmatism (P > 0.10), preoperative and postoperative visual acuity (P > 0.10), diameter of graft and trephine (P > 0.15), and oversize of the graft (P > 0.50). Postoperati ve IOP measurements were significantly (P < 0.01) correlated with preoperat ive IOP values. Conclusions: In eyes with a peripheral iridotomy performed during surgery, homologous central penetrating keratoplasty usually does not markedly chang e IOP. The main risk factor far postoperatively increased IOP is increased IOP before surgery.