Penetrating keratoplasty in adults with congenital glaucomas

Abstract

Purpose. To report the problems and outcomes of penetrating keratoplasty (PKP) in patients with corneal oedema due to congenital glaucoma. Method. Case note review of nine such consecutive patients treated with PKP. A Kaplan - Meir survival curve was plotted for the series. Results. Nine patients, ranging in age from 27 to 71 years at the time of their surgery were followed up for a mean of 28 months. All had undergone previous surgery for glaucoma. Preoperatively all patients had controlled intraocular pressures, and four were on ocular hypotensives. Two patients developed corneal graft failure at 15 and 41 months postoperative. Raised pressure was the cause in both. Final visual acuity improved in five patients, was the same in three, and deteriorated in only one. Complications included raised intraocular pressure, cataract, retinal detachment, and endophthalmitis secondary to an infected Molteno implant. Conclusion. Despite multiple impediments to good postoperative vision including previous surgery and pre-existing glaucomatous damage, a successful outcome was achieved by careful patient selection, and an awareness of, and meticulous attention to postoperative complications. © 2004 Nature Publishing Group All rights reserved.