Jonas J B, Rank R M, Hayler J K, Budde W M
Department of Ophthalmology and Eye Hospital, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
J Glaucoma. 2001 Feb;10(1):32-7. doi: 10.1097/00061198-200102000-00007.
To evaluate intraocular pressure (IOP) changes after homologous central penetrating keratoplasty in a noncomparative interventional case series.
The study included 245 patients undergoing homologous central penetrating keratoplasty for keratoconus (n = 77), herpetic corneal scars (n = 29), nonherpetic corneal scars (n = 46), Fuchs endothelial dystrophy (n = 24), and secondary corneal endothelial decompensation caused by preceding intraocular operations (n = 69). Mean follow-up time was 30.4 +/- 18.7 months (range, 12.1-111.6 months). The same surgeon operated on all patients, and a peripheral iridotomy was routinely performed.
On the first postoperative day, IOP was significantly (P = 0.02) higher than that before keratoplasty. Taking the whole study group and taking the study groups separately, IOP measurements determined on the third postoperative day (P = 0.57), 1 week after surgery (P = 0.55), or later (P > 0.50) were not significantly different from the preoperative values. Eyes undergoing keratoplasty with cataract surgery and eyes undergoing keratoplasty without additional intraocular procedures did not vary significantly (P > 0.10) in IOP measurements. IOP did not differ significantly (P > 0.50) between eyes with an immunologic graft reaction (n = 29) and eyes without a reaction (n = 216). Acute angle-closure glaucoma was not detected in any of the patients. IOP measurements were statistically independent of suture type (P > 0.10), age (P > 0.05), preoperative and postoperative refractive error (P > 0.05), preoperative and postoperative corneal astigmatism (P > 0.10), preoperative and postoperative visual acuity (P > 0.10), diameter of graft and trephine (P > 0.15), and oversize of the graft (P > 0.50). Postoperative IOP measurements were significantly (P < 0.01) correlated with preoperative IOP values.
In eyes with a peripheral iridotomy performed during surgery, homologous central penetrating keratoplasty usually does not markedly change IOP. The main risk factor for postoperatively increased IOP is increased IOP before surgery.
在一个非对照性介入病例系列中评估同种异体中央穿透性角膜移植术后的眼压（IOP）变化。
该研究纳入了245例行同种异体中央穿透性角膜移植术的患者，其中圆锥角膜患者77例，疱疹性角膜瘢痕患者29例，非疱疹性角膜瘢痕患者46例，富克斯内皮营养不良患者24例，以及既往眼内手术导致的继发性角膜内皮失代偿患者69例。平均随访时间为30.4±18.7个月（范围12.1 - 111.6个月）。所有患者均由同一位外科医生进行手术，且常规行周边虹膜切开术。
术后第1天，眼压显著高于角膜移植术前（P = 0.02）。以整个研究组以及分别以各个研究组来看，术后第3天（P = 0.57）、术后1周（P = 0.55）或之后（P > 0.50）所测眼压与术前值无显著差异。行角膜移植联合白内障手术的眼与仅行角膜移植未进行其他眼内手术的眼，眼压测量值无显著差异（P > 0.10）。有免疫性移植反应的眼（n = 29）与无反应的眼（n = 216）之间眼压无显著差异（P > 0.50）。所有患者均未检测到急性闭角型青光眼。眼压测量值在统计学上与缝线类型（P > 0.10）、年龄（P > 0.05）、术前和术后屈光不正（P > 0.05）、术前和术后角膜散光（P > 0.10）、术前和术后视力（P > 0.10）、植片和环钻直径（P > 0.15）以及植片过大情况（P > 0.50）无关。术后眼压测量值与术前眼压值显著相关（P < 0.01）。
在手术中进行了周边虹膜切开术的眼中，同种异体中央穿透性角膜移植术通常不会明显改变眼压。术后眼压升高的主要危险因素是术前眼压升高。
