Incidence of increased intraocular pressure and factors associated with it after optical penetrating keratoplasty at secondary care centre, India

Abstract

Background: An increase in intraocular pressure (IOP/glaucoma) any time after penetrating keratoplasty (PK) leads to a significant endothelial cell loss with dire consequences. The present study was conducted to know the incidence of increased IOP and factors associated with it following optical PK. Materials and Methods: A prospective study was conducted at Ophthalmology Department of PDU Medical College and Civil Hospital Rajkot, a secondary level center for 2 years from May 2010 to April 2012. A total of 50 patients admitted for optical PK during the study period were enrolled. Detailed history was elicited regarding ocular problem and any treatment taken for the same. Results: Nearly 30% of the patients reported an increase in IOP in the present study. Majority (58.0%) patients were above the age of 55 years. Based on preoperative diagnosis, increase in IOP was reported among patients with aphakic bullous keratopathy (100.0%), adherent leucoma (50.0%), graft failure (44.4%) and pseudophakic bullous keratopathy (25.0%). After 1 month of optical PK, 18.0% patients reported an increase in IOP, 28.0% after 2 months and 26.0% after 3 months. Out of 15 patients who reported an increase in IOP, 14 (93.3%) were given medical treatment and 1 (6.7%) patient required surgical treatment. Conclusion: Age above 55 years, preoperative diagnosis of adherent leucoma, aphakic eyes were major risk factors for the post-operative increase in IOP in the present study. Peak rise in IOP was reported following 2 months post keratoplasty. Post PK glaucoma in the majority of patients responded to medical treatment.