Postoperative Increase in Intraocular Pressure After Penetrating Keratoplasty and Descemet Stripping Automated Endothelial Keratoplasty in Asian Patients

Purpose: We compared factors that contribute to postoperative intraocular pressure (IOP) elevation after penetrating or Descemet stripping automated endothelial keratoplasty in Asian patients. Methods: Consecutive patients who underwent corneal transplantation by penetrating or Descemet stripping automated endothelial keratoplasty were included. IOP was recorded preoperatively and at every postoperative visit for 2 years. Demographic factors and preoperative and maximum postoperative IOP were statistically compared between the groups. IOP elevation risk factors were identified using the log-rank test and multivariate Cox proportional hazards regression analysis with time-dependent covariates. Results: Twenty-two patients with penetrating keratoplasty (13 men, 9 women; aged 55.0 ± 21.6 years) and 46 patients with Descemet stripping automated endothelial keratoplasty (20 men, 26 women; aged 76.7 ± 10.7 years) were included. Preoperative IOP was lower in eyes treated with penetrating keratoplasty (10.5 ± 3.6 mm Hg, measurements of 2 cases were not recorded) than in eyes treated with Descemet stripping automated endothelial keratoplasty (14.0 ± 3.4 mm Hg, P < 0.001). Postoperative maximum IOP was higher in penetrating keratoplasty (21.1 ± 6.2 mm Hg) than in Descemet stripping automated endothelial keratoplasty (15.8 ± 5.3, P < 0.001). Intraocular pressure was elevated in 11 (50%) and 9 (19.6%) eyes treated with penetrating and Descemet stripping automated endothelial keratoplasty, respectively. Penetrating keratoplasty was identified as a risk factor for IOP elevation. Conclusions: Postoperative IOP elevation was more likely to occur after penetrating keratoplasty than after Descemet stripping automated endothelial keratoplasty. Postoperative IOP should be carefully monitored and managed in patients after corneal transplantation.