Risk factors for intraocular pressure elevation after descemet stripping automated endothelial keratoplasty

Meredith B. Allen, Philip Lieu, Venkateswara Mootha, Robert W Bowman, Walter M Petroll, Liyue Tong, Karanjit S Kooner, Harrison D Cavanagh, Jess T Whitson, Nalini K. Aggarwal

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Purpose:: To identify the incidence of and risk factors for intraocular pressure (IOP) elevation after Descemet stripping automated endothelial keratoplasty (DSAEK). Methods:: Retrospective review was conducted of 68 consecutive DSAEK procedures alone, or in combination with phacoemulsification with intraocular lens implantation or exchange, performed by two surgeons at the University of Texas Southwestern Medical Center between 2005 and 2009. Eyes that developed IOP elevation above 21 mm Hg after DSAEK and requiring initiation or escalation of glaucoma therapy were evaluated. Results:: Thirty-seven (54%) eyes showed IOP elevation responsive to medical treatment by a mean follow-up of 11.38 ± 7.81 months. Six (8.8%) eyes required glaucoma surgery. In the eyes, which developed elevated IOP, gonioscopy did not reveal any new peripheral anterior synechiae formation. Prolonged topical steroid usage, rebubbling, combined DSAEK/cataract surgery, or repeat DSAEK were not significant factors (P>0.05) for development of elevated IOP, but history of previous glaucoma or ocular hypertension (OHTN) was significant (P=0.007). Conclusions:: Intraocular pressure elevation is not uncommon in eyes after DSAEK, but most cases can be controlled with conservative management. Intraocular pressure elevation post-DSAEK occurred by mechanisms other than peripheral anterior synechial angle closure. The only significant risk factor for development of elevated IOP in our series was a previous history of glaucoma or OHTN.

Original languageEnglish (US)
Pages (from-to)223-227
Number of pages5
JournalEye and Contact Lens
Volume36
Issue number4
DOIs
StatePublished - Jul 2010

Keywords

  • DSAEK
  • Descemet stripping automated endothelial keratoplasty
  • Glaucoma

ASJC Scopus subject areas

  • Ophthalmology

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