Simmons R B, Stern R A, Teekhasaenee C, Kenyon K R
Cornea Service, Massachusetts Eye and Ear Infirmary.
Trans Am Ophthalmol Soc. 1989;87:79-91; discussion 91-3.
IOP was retrospectively studied in 229 consecutive cases of PK, with a mean follow-up period of 84 weeks. Twenty-seven percent of the cases had preoperative glaucoma, three-fourths of which were medically controlled prior to keratoplasty. Following PK, 34% of the total sample developed sustained elevated IOP but only five (2%) patients required surgical treatment for glaucoma. The mean time from PK to first IOP rise was 24 weeks. Variables which were significantly associated with IOP rise included preoperative glaucoma (P less than .001), aphakia (P less than .01), and IOL removal (P less than .01). When eyes with preoperative diagnoses of glaucoma were excluded from the analysis, aphakia was no longer associated with postoperative IOP rise. Keratoconus patients were at significantly less risk than patients with other corneal diagnoses. Factors not associated with IOP rise included previous PKs, pseudophakia, intraoperative vitrectomy, PAS lysis, iridoplasty, secondary IOL placement, and concomitant cataract extraction with IOL (triple procedure).
对229例连续的穿透性角膜移植术（PK）病例的眼压进行了回顾性研究，平均随访期为84周。27%的病例术前患有青光眼，其中四分之三在角膜移植术前通过药物控制。PK术后，34%的总样本出现持续性眼压升高，但只有5例（2%）患者需要接受青光眼手术治疗。从PK到首次眼压升高的平均时间为24周。与眼压升高显著相关的变量包括术前青光眼（P<0.001）、无晶状体眼（P<0.01）和人工晶状体取出（P<0.01）。当分析中排除术前诊断为青光眼的眼睛时，无晶状体眼与术后眼压升高不再相关。圆锥角膜患者的风险明显低于其他角膜诊断的患者。与眼压升高无关的因素包括既往PK手术、人工晶状体眼、术中玻璃体切除术、周边虹膜前粘连松解、虹膜成形术、二期人工晶状体植入以及白内障摘除联合人工晶状体植入（三联手术）。
