Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, Japan.
Jpn J Ophthalmol. 2012 Jul;56(4):307-11. doi: 10.1007/s10384-012-0149-0. Epub 2012 May 30.
To investigate the incidence of intraocular pressure (IOP) elevation after Descemet's stripping endothelial keratoplasty (DSEK) and associated clinical findings.
Forty-eight eyes of 46 patients who underwent DSEK were studied in this single-center retrospective study. IOP elevation was defined as the presence of an increase in IOP above 21 mmHg lasting at least two months, the need to introduce topical/oral antiglaucoma medications for at least two months, and the need for surgical therapy for uncontrolled IOP. Patients with pre-existing glaucoma or patients who were using antiglaucoma drugs before DSEK were excluded according to the protocol of the study. The incidence of post-DSEK IOP elevation was investigated.
The incidence of IOP elevation after DSEK was 16.7 %. Glaucoma therapy following DSEK was needed in eight eyes of eight patients. IOP elevations were diagnosed from two to ten months after DSEK. There was no statistical difference in the survival probabilities of patients with different preoperative diagnoses. Pre-op IOP was observed to be a risk factor of IOP elevation in this series.
IOP elevation appears to be a common postoperative complication of DSEK. Patients without preexisting glaucoma but with higher pre-op IOP need to be followed up carefully after DSEK.
研究撕囊内皮角膜移植术（DSEK）后眼压升高的发生率及相关临床发现。
本单中心回顾性研究纳入了 46 例 48 只眼行 DSEK 的患者。眼压升高的定义为：眼压升高持续至少 2 个月，眼压超过 21mmHg，需要至少 2 个月的局部/口服抗青光眼药物治疗，以及需要手术治疗来控制眼压。根据研究方案，排除了术前患有青光眼或正在使用抗青光眼药物的患者。研究了 DSEK 后眼压升高的发生率。
DSEK 后眼压升高的发生率为 16.7%。8 例 8 只眼需要行 DSEK 后青光眼治疗。眼压升高在 DSEK 后 2 至 10 个月诊断。不同术前诊断的患者的生存率无统计学差异。本系列中，术前眼压是眼压升高的一个危险因素。
眼压升高似乎是 DSEK 术后常见的并发症。无原发性青光眼但术前眼压较高的患者 DSEK 后需要密切随访。
