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Challenges in the complex management of post-keratoplasty glaucoma
Lisa-Marie Anders1, Zisis Gatzioufas2, Matthias C Grieshaber3
1Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.
Therapeutic Advances in Ophthalmology
|August 5, 2021
Summary
Post-keratoplasty glaucoma, a major cause of vision loss after corneal transplants, is reviewed. This study examines its causes, diagnosis, and treatments, comparing different keratoplasty methods.
Area of Science:
- Ophthalmology
- Transplantation Surgery
Background:
- Glaucoma is a significant complication following corneal transplantation, often leading to graft failure and vision loss.
- Corneal endothelial decompensation is a primary driver of vision loss post-keratoplasty.
- Elevated intraocular pressure (IOP) and glaucoma development are critical concerns after corneal procedures.
Purpose of the Study:
- To review the pathophysiology of post-keratoplasty glaucoma.
- To discuss diagnostic tools and their limitations in measuring IOP post-transplantation.
- To present current treatment modalities for managing glaucoma after corneal grafts.
Main Methods:
- Review of existing literature on post-keratoplasty glaucoma.
- Analysis of diagnostic devices for IOP measurement in this context.
- Evaluation of treatment strategies for elevated IOP and glaucoma.
Main Results:
- Endothelial keratoplasty (DSAEK, DMEK) may have a lower incidence of IOP elevation and glaucoma compared to penetrating keratoplasty (PK).
- Certain corneal diseases (e.g., pseudophakic bullous keratopathy, perforation, rejection) carry a higher risk of post-keratoplasty glaucoma.
- Some conditions respond less effectively to IOP-lowering therapies.
Conclusions:
- Understanding the pathophysiology and risk factors is crucial for managing post-keratoplasty glaucoma.
- Accurate IOP measurement and appropriate treatment selection are vital for graft survival and vision preservation.
- Further research may refine diagnostic and therapeutic approaches for this complex condition.
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