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Posterior keratoplasty associated with less postop glaucoma

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SNOWBIRD, Utah — Penetrating keratoplasty was associated with a higher incidence of glaucoma than a microkeratome-assisted posterior keratoplasty procedure, according to a retrospective study. The posterior technique may be more benign because it reduces angle distortion, said Ramesh Ayyala, MD, here at the American Glaucoma Society meeting.

Dr. Ayyala and colleagues reviewed the records of patients who had undergone penetrating keratoplasty (PK) or microkeratome-assisted posterior penetrating keratoplasty (MAPPK). Fifteen patients underwent PK, and 16 underwent MAPPK, he said. The baseline IOP was 13 mm Hg in the PK group and 15 mm Hg in the MAPPK group. Follow-up was at 1, 3 and 6 months and 1 year.

At 1 month, mean IOP was 15.8 mm Hg in the PK group and 10.4 mm Hg in the MAPPK group. At 3 months, it was 21.67 mm Hg in the PK group and 15.87 mm Hg in the MAPPK group. At 6 months, it was 15.9 mm Hg in the PK group and 13 mm Hg in the MAPPK group. At 1 year, IOP was 17 mm Hg in the PK group and 13.75 mm Hg in the MAPPK group.

Dr. Ayyala said that by not disturbing the angle, MAPPK reduced the incidence of postoperative glaucoma. In the PK group, 30% of patients with no previous glaucoma developed glaucoma after the surgery, he said.