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Glaucoma in patients with corneal endothelial dystrophy
Zahra K Ali1, Jess T Whitson, V Vinod Mootha
1UT Southwestern Medical Center, Dallas, TX 75390, USA.
Eye & Contact Lens
|September 14, 2011
Summary
This study found no increased risk of primary open-angle glaucoma (POAG) in patients with corneal endothelial dystrophy. However, ocular hypertension and secondary glaucoma rates were higher after penetrating keratoplasty compared to Descemet stripping endothelial keratoplasty.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Corneal Diseases
Background:
- Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
- Corneal endothelial dystrophies affect the inner layer of the cornea.
- The relationship between POAG and corneal endothelial dystrophy is not well-established.
Purpose of the Study:
- To investigate the prevalence of POAG in patients with corneal endothelial dystrophy.
- To compare POAG prevalence in this cohort with the general population.
- To analyze ocular hypertension and secondary glaucoma rates after different corneal transplant procedures.
Main Methods:
- Retrospective case-control study design.
- Analysis of 430 eyes from 215 patients with endothelial dystrophy.
- Age- and race-matched controls from population-based eye surveys were used for comparison.
Main Results:
- No statistically significant increased risk of POAG was observed in patients with endothelial dystrophy across different ethnicities.
- Relative risk of POAG was 0.94 (white), 2.59 (African American), and 3.7 (Hispanic).
- Higher rates of ocular hypertension/secondary glaucoma were found after penetrating keratoplasty (PK) compared to Descemet stripping endothelial keratoplasty (DSEK).
Conclusions:
- Corneal endothelial dystrophy does not appear to increase the risk of primary open-angle glaucoma.
- Penetrating keratoplasty (PK) is associated with a higher incidence of ocular hypertension and secondary glaucoma than Descemet stripping endothelial keratoplasty (DSEK).
- Potential mechanisms for increased complications after PK include suture-related issues and prolonged steroid use.
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