A prospective study of incidence and risk factors for secondary glaucoma after penetrating keratoplasty

Aim: To carry out a prospective study to analyze the incidence and risk factors for secondary glaucoma after penetrating keratoplasty (PK). Materials and Methods: Three hundred and eleven consecutive penetrating keratoplasties that were performed between January 1, 2006, and December 31, 2008, with a follow-up of 12 months were prospectively analyzed to determine the factors associated with postoperative glaucoma. Results: Of 311 eyes, secondary glaucoma developed in 57 cases. This yields an incidence of 18.3%. In conditions, such as aphakic bullous keratopathy, the incidence of post-PK glaucoma was 3.0%; in pseudophakic bullous keratopathy 14.0%, and in cases of failed graft 16.0%, while in cases of corneal ulcer and corneal opacity it was 49.0% and 18.0%, respectively. Conclusion: We conclude in our study that the incidence of glaucoma developing post-PK was highest in phakic eyes, which may be due to the formation of posterior synechiae and development of intumescent cataract. Higher incidence of glaucoma developing in infective cases could be due to recipient hot eye and the high incidence in cases of large graft could be attributed to the formation of peripheral anterior synechiae