Surgery for glaucoma in modern corneal graft procedures

Area of Science:

• Ophthalmology
• Transplantation Surgery

Background:

• Glaucoma is a significant cause of vision loss and corneal graft failure.
• Increased intraocular pressure (IOP) can occur pre-existing or post-keratoplasty in up to 33% of patients.
• Pre-keratoplasty glaucoma necessitates medical or surgical control.

Purpose of the Study:

• To review the impact of glaucoma on corneal transplant outcomes.
• To discuss the management of pre-existing and post-keratoplasty glaucoma.
• To highlight risk factors and management strategies for elevated IOP after keratoplasty.

Main Methods:

• Review of existing literature on glaucoma and keratoplasty.
• Analysis of glaucoma prevalence and risk factors in corneal transplant patients.
• Comparison of glaucoma incidence and management across different keratoplasty techniques.

Main Results:

• Anterior lamellar keratoplasty shows reduced rates of post-keratoplasty glaucoma.
• Endothelial keratoplasties present challenges with IOP spikes, primarily due to air bubbles, but are generally less severe and easier to manage than penetrating keratoplasty.
• Identifying risk factors aids in appropriate follow-up and management of post-keratoplasty IOP.

Conclusions:

• Adequate glaucoma management before and after keratoplasty is vital for preventing irreversible optic nerve damage.
• Optimizing IOP control enhances corneal graft survival rates.
• Understanding specific risks associated with different keratoplasty types informs patient care.