4.5 Review

Surgery for glaucoma in modern corneal graft procedures

Journal

SURVEY OF OPHTHALMOLOGY
Volume 66, Issue 2, Pages 276-289

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.survophthal.2020.08.002

Keywords

glaucoma; glaucoma surgery; corneal transplant; penetrating keratoplasty; lamellar keratoplasty; endothelial keratoplasty; corneal graft; graft survival

Categories

Funding

  1. Network for Cooperative Research in Health OFTARED, Nodo Dioptrio Ocular, Biobanco Iberia [RD16/0008/0012]
  2. Instituto de Salud Carlos III
  3. European Regional Development Fund (ERDF), Project A way to make Europe

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Glaucoma is a common cause of vision loss after corneal transplantation and requires control before surgery. Appropriate follow-up and management can help patients with postoperative increase in intraocular pressure. Adequate management of glaucoma can prevent irreversible damage to the eyes and increase graft survival.
Glaucoma is a common cause of vision loss after corneal transplantion and is considered a major risk factor for graft failure. Glaucoma may be present before corneal transplant surgery, or increased intraocular pressure may develop after keratoplasty in up to onethird of patients. Pre-existing glaucoma should be controlled before keratoplasty, either medically or surgically. For postkeratoplasty increase in intraocular pressure; identifying the risk factors allows appropiate follow-up and management. Patients undergoing anterior lamellar keratoplasty may take advantage of reduced rates of postkeratoplasty glaucoma. Glaucoma also complicates eyes with endothelial keratoplasties, mostly related to management of intraocular pressure spikes derived from anterior chamber air bubbles. Nevertheless, the severity is less, and the intraocular pressure is more easily controlled when compared with penetrating keratoplasty. Adequate management of glaucoma that develops before or after keratoplasty may save eyes from irreversible damage to the optic nerve and increase graft survival. (c) 2020 Elsevier Inc. All rights reserved.

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