Glaucoma Following Penetrating Keratoplasty (PKP) Is One Of The Most Common Causes For Irreversible Visual Loss And The Second Leading Cause For Graft Failure After Rejection. The Management Of Penetrating Keratoplasty And Glaucoma (PKPG) Remains Controversial Mainly Because Of The High Risk Of Graft Failure Associated With The Treatment.
Full Thickness GraftThis Is Becoming Performed Less And Less Often With The Advance Of New Techniques And Technology.
This Procedure Involves Removal Of The Whole Cornea (All 5 Layers) And Replacement With A Full Thickness Cornea From A Donor. The Cornea Is Stitched Into Place Using Stitches Of 20 Microns (40% The Thickness Of Human Hair!).
Stitches Are Typically Removed At One Year. It Can Also Take About This Time Frame For Vision To Be Restored To A Satisfactory Level. Often Patients Who Have Had A Penetrating Keratoplasty Require Glasses Or Contact Lenses For Visual Correction.
- Good Optical Clarity
- Risk Of Open Eye Surgery - Haemorrhage, Infection
- Risk Of Graft Rejection - Rejection To Endothelial (Innermost Layer), Which Can Lead To Loss Of Vision
- Stitch Related Problems
Risk Factors For Glaucoma In Patients Undergoing PK Include : -
- Aphakic And Pseudophakic Bullous Keratopathy
- Mesodermal Dysgenesis
- Irido-Corneal-Endothelial Syndrome
- Pre-Existing Glaucoma
- Perforated Corneal Ulcer
- Adherent Leukoma
- Previous PK
- Post-Traumatic Cases
- Combined PK And Cataract Extraction
- Performance Of Vitrectomy During PK
PrecautionsCorneal Transplant Is A Very Safe Procedure That Can Be Performed On Almost Any Patient Who Would Benefit From It. Any Active Infection Or Inflammation Of The Eye Usually Needs To Be Brought Under Control Before Surgery Can Be Performed.
AftercareCorneal Transplant Is Often Performed On An Outpatient Basis, Although Some Patients Need Brief Hospitalization After Surgery. The Patient Will Wear An Eye Patch At Least Overnight. An Eye Shield Or Glasses Must Be Worn To Protect The Eye Until The Surgical Wound Has Healed. Eye Drops Will Be Prescribed For The Patient To Use For Several Weeks After Surgery.
These Drops Include Antibiotics To Prevent Infection As Well As Corticosteroids To Reduce Inflammation And Prevent Graft Rejection.
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