Risk factors for the development of postkeratoplasty glaucoma.

From a database of 1,122 penetrating keratoplasties performed under the care of the surgeons of the Corneal Clinic, Moorfields Eye Hospital (London, U.K.), 153 (14%) were identified as being complicated by postkeratoplasty glaucoma. The relative risk for its development varied with the indication for keratoplasty. Keratoconus had the lowest incidence along with some dystrophies, such as macular or granular dystrophy, and these were taken as the baseline for comparison. Anterior chamber dysgenesis syndromes had the highest risk among the indications for keratoplasty. Combined cataract or lens implant surgery was also found to be a risk factor, with anterior vitrectomy, anterior segment revision, and anterior chamber lens implant removal representing a greater risk than extracapsular extraction and posterior chamber lens implantation. Postkeratoplasty glaucoma was also strongly associated with peripheral anterior synechiae formation seen after keratoplasty.