Department of Glaucoma, Dr. Shroff's Charity Eye Hospital, New Delhi, India.
Indian J Ophthalmol. 2022 Apr;70(4):1239-1245. doi: 10.4103/ijo.IJO_1470_21.
To carry out a prospective study to analyze the incidence and various preoperative, intraoperative, and postoperative risk factors for the development of PPKG.
A total of 207 patients were analyzed prospectively, who were operated for penetrating keratoplasty (PK) in a tertiary eye care hospital between the time period of August 1, 2017 and February 28, 2018 and were followed up till the sixth month. Each patient was analyzed at every visit to determine the factors responsible for post-keratoplasty glaucoma.
Out of 207 eyes, post-PK glaucoma developed in 84 cases, which yielded an incidence of 41%. Incidence of PPKG (Post PK glaucoma) in various conditions was as follows: in repeat PK 62%, in perforated corneal ulcer 33%, in nonperforated corneal ulcer 29%, in corneal scar including adherent leukoma 37.2%, and in pseudophakic bullous keratopathy and aphakic bullous keratopathy, 14% and 80%, respectively. In age- and sex-adjusted multivariate analysis, the significant risk factors were age (P-value- 0.006), presence of PAS (P-value 0.001), and fellow eye glaucoma (P-value 0.04). Aphakia and combined surgery were not found to be significant.
Our study recommends a meticulous examination of the fellow eye to assess the presence of glaucoma as it can increase the suspicion of glaucoma in the eye to be operated. The presence of PAS and age are important risk factors for developing PPKG. The risk of developing PPKG increases exponentially as the number of risk factors increases, but the presence of more than three risk factors does not add to the development of PPKG.
进行一项前瞻性研究，分析穿透性角膜移植术后发生青光眼（PPKG）的发生率及各种术前、术中、术后的危险因素。
对 2017 年 8 月 1 日至 2018 年 2 月 28 日期间在一家三级眼科医院接受穿透性角膜移植术（PK）的 207 例患者进行前瞻性分析，并随访至第六个月。每次就诊时对每位患者进行分析，以确定导致移植术后青光眼的因素。
在 207 只眼中，84 只（41%）发生了 PK 后青光眼。在各种情况下，PPKG（穿透性角膜移植术后青光眼）的发生率如下：再次 PK 为 62%，穿透性角膜溃疡为 33%，非穿透性角膜溃疡为 29%，角膜瘢痕包括粘连性白斑为 37.2%，而在假性和无晶状体性大疱性角膜病变中，分别为 14%和 80%。在年龄和性别调整的多变量分析中，显著的危险因素是年龄（P 值为 0.006）、前房角渗出（P 值为 0.001）和对侧眼青光眼（P 值为 0.04）。无晶状体和联合手术不是显著的危险因素。
我们的研究建议仔细检查对侧眼，以评估青光眼的存在，因为它可以增加对即将手术眼的青光眼的怀疑。前房角渗出和年龄是发生 PPKG 的重要危险因素。随着危险因素数量的增加，发生 PPKG 的风险呈指数级增加，但超过三个危险因素的存在并不会增加 PPKG 的发生。
