Escalation of glaucoma therapy after penetrating keratoplasty

Mansour Al-Mohaimeed; Sami Al-Shahwan; Abdullah Al-Torbak; Michael D Wagoner

doi:10.1016/j.ophtha.2007.08.043

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Escalation of glaucoma therapy after penetrating keratoplasty

Journal article

Peer reviewed

Escalation of glaucoma therapy after penetrating keratoplasty

Mansour Al-Mohaimeed, Sami Al-Shahwan, Abdullah Al-Torbak and Michael D Wagoner

Ophthalmology (Rochester, Minn.), Vol.114(12), pp.2281-2286

12/2007

DOI: 10.1016/j.ophtha.2007.08.043

PMID: 18054642

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Abstract

To determine the prevalence and risk factors for escalation of glaucoma therapy after penetrating keratoplasty (PK) and its impact on graft survival and visual outcome. Retrospective case series. Seven hundred fifteen consecutive eyes of 678 patients undergoing PK. Retrospective review of every case of PK performed at King Khaled Eye Specialist Hospital between January 1, 2001 and December 31, 2002. Escalation of glaucoma therapy, graft survival, and visual outcome. Escalation of glaucoma therapy occurred in 89 (12.4%) eyes of 715 PK procedures during a mean follow-up of 32.2 months. Medical escalation accounted for 73 (82.0%) cases, whereas surgical escalation occurred in 16 (18.0%) eyes. The following were significantly associated with an increased risk of escalation of glaucoma therapy: surgical indication for PK (P<0.001), increasing patient age (P<0.001), preexisting glaucoma (P<0.001), recipient trephination < 7.0 mm (P = 0.02), and pseudophakia or aphakia (P<0.001). Eyes with escalation of glaucoma therapy had significant reduction in graft survival compared with eyes in which this did not occur (52.8% vs. 82.9%, P<0.001). Escalation of glaucoma therapy was associated with a significant reduction in the percentage of eyes achieving visual acuity of 20/40 or better (9.0% vs. 42.1%, P<0.001) and a significant increase in those obtaining 20/200 or worse (70.8% vs. 26.7%, P<0.001). Escalation of glaucoma therapy is a serious sequela of PK that is significantly associated with an increased risk of graft failure and poor visual outcome.

Glaucoma - etiology

Prevalence

Intraocular Pressure

Humans

Middle Aged

Risk Factors

Antihypertensive Agents - administration & dosage

Child, Preschool

Infant

Male

Filtering Surgery - utilization

Adolescent

Keratoplasty, Penetrating

Aged, 80 and over

Graft Survival - physiology

Adult

Female

Glaucoma - therapy

Aged

Retrospective Studies

Child

Postoperative Complications

Visual Acuity - physiology

Glaucoma - physiopathology

Details

Title: Subtitle: Escalation of glaucoma therapy after penetrating keratoplasty
Creators: Mansour Al-Mohaimeed - Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
Sami Al-Shahwan
Abdullah Al-Torbak
Michael D Wagoner
Resource Type: Journal article
Publication Details: Ophthalmology (Rochester, Minn.), Vol.114(12), pp.2281-2286
Publisher: United States
DOI: 10.1016/j.ophtha.2007.08.043
PMID: 18054642
ISSN: 0161-6420
eISSN: 1549-4713
Language: English
Date published: 12/2007
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983980022102771

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