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Incidence and risk factors of elevated intraocular pressure following deep anterior lamellar keratoplasty
Author(s) -
Huang O.,
Mehta J.,
Htoon H.,
Tan D.,
Wong T.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0275
Subject(s) - medicine , intraocular pressure , incidence (geometry) , glaucoma , ophthalmology , retrospective cohort study , surgery , physics , optics
Purpose To report the rates of elevated IOP following deep anterior lamellar keratoplasty (DALK). Methods A retrospective study investigating the 5‐year incidence of raised IOP following DALK cases performed from 2004 to 2008 in a tertiary centre. Patients with less than 6 months of follow‐up were excluded. Elevated IOP was defined as IOP > 21 mmHg. Results An episode of elevated IOP occurred in 36.1% ( n = 44) of 122 cases, 11.4% ( n = 5) occurring within the first week. The average duration of raised IOP was 48.9 (SD: 65.5) days. Causes included pupil block from air, swollen grafts, and corticosteroid response. Surgical intervention to lower IOP was required in 3 (6.8%) cases. In multivariate analyses, the use of patanol 0.1% or the use of ciclosporin eyedrops before DALK (OR = 14.51, 95%CI = 1.43–147.23) and the type of topical corticosteroid use post‐DALK (OR = 4.79, 95%CI = 0.73–31.52) were found to be associated with higher rates of elevated IOP post DALK. At 5 years post DALK, 3/71 cases (4.48%) developed de novo glaucomatous field defects, and 1 case with pre‐existing glaucoma had progression of glaucomatous field defect. Conclusions DALK was associated with a significant incidence of transiently elevated IOP post‐operatively, but had a low incidence of de novo glaucoma at 5 years in our study. Risk factors for elevated IOP post DALK included the prior use of patanol 0.1% or ciclosporin eyedrops and the type of topical corticosteroid used following DALK.