Incidence and risk factors for glaucoma development and progression after corneal transplantation.
Journal
Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986
Informations de publication
Date de publication:
07 2023
07 2023
Historique:
received:
10
01
2022
accepted:
18
10
2022
revised:
03
10
2022
pmc-release:
01
07
2024
medline:
12
7
2023
pubmed:
5
11
2022
entrez:
4
11
2022
Statut:
ppublish
Résumé
To assess the cumulative incidence and risk factors for glaucoma development and progression within 1-2 years following corneal transplant surgery. Retrospective cohort study. Patients undergoing penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), Descemet stripping endothelial keratoplasty (DSEK), Descemet membrane endothelial keratoplasty (DMEK), Boston keratoprosthesis type I (KPro) implantation, or endothelial keratoplasty (DSEK or DMEK) under previous PK (EK under previous PK) at one academic institution with at least 1 year of follow-up were included. Primary outcome measures were cumulative incidence of glaucoma development and progression after corneal transplant, in patients without and with preoperative glaucoma, respectively. Risk factors for glaucoma development and progression were also assessed. Four hundred and thirty-one eyes of 431 patients undergoing PK (113), DALK (17), DSEK (71), DMEK (168), KPro (35) and EK under previous PK (27) with a mean follow-up of 22.9 months were analyzed. The 1-year cumulative incidence for glaucoma development and progression was 28.0% and 17.8% in patients without and with preoperative glaucoma, respectively. In a Cox proportional hazards analysis, DSEK surgery, KPro implantation, average intraocular pressure (IOP) through follow-up and postoperative IOP spikes of ≥30 mmHg were each independently associated with glaucoma development or progression (p < 0.04 for all). A significant proportion of patients developed glaucoma or exhibited glaucoma progression within 1 year after corneal transplantation. Patient selection for DSEK may partly explain the higher risk for glaucoma in these patients. Postoperative IOP spikes should be minimized and may indicate the need for co-management with a glaucoma specialist.
Identifiants
pubmed: 36329167
doi: 10.1038/s41433-022-02299-6
pii: 10.1038/s41433-022-02299-6
pmc: PMC10333209
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2117-2125Informations de copyright
© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.
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