Incidence of raised intra-ocular pressure post penetrating keratoplasty at a tertiary care hospital in central India

Abstract

Background: Penetrating keratoplasty (PK) is done for a variety of reasons, such as corneal opacity, bullous keratopathy, corneal stromal dystrophies, Fuchs' endothelial dystrophy, ectasia, and perforation. Management of raised intra-ocular pressure (IOP) after keratoplasty is necessary to maintain the visual outcome. The purpose of this study was to find the incidence of raised IOP after keratoplasty. Material and Methods: This prospective study was conducted on 67 eyes of 67 patients attending the ophthalmic out-patient department of the upgraded department of MY Hospital Indore from November 2021 to November 2022. One-way analysis of variance test, Chi-square test, and Fisher exact test were applied, and the P value was judged at 5% level of significance. Results: The main indication for PK was infectious keratitis (52.3%), corneal scars (32.8%), regrafts (7.5%), bullous keratopathy (5.9%), and staphyloma (2.9%). In this study, the overall incidence of raised IOP (>21 mmHg) was 25.37% (17 cases). Raised IOP was observed among the 20% of infectious keratitis, 27.3% of corneal scars, 40% of regraft, and 50% of bullous keratopathy. Steroid-induced rise in IOP (47.05%; n = 8) was the most common post-operative factor. Conclusion: Maximum cases in which PK was done were of infectious keratitis. Post PK rise in IOP is a serious complication that is significantly associated with an increased risk of graft failure and poor visual outcome. Thus, rise in IOP was associated with a significant reduction in the percentage of eyes achieving good visual acuity.

Keywords

• corneal scar
• infectious keratitis
• regraft