Purpose: To evaluate the incidence of secondary glaucoma after repeated corneal transplantation, associated risk factors, treatment and outcome.
Methods: All the charts of patients that underwent repeated corneal transplantation between 1985 and 1998 were reviewed for the occurrence of secondary glaucoma. Eighty patients underwent 122 repeated corneal transplantation, of which six underwent surgery in both eyes. Follow-up period was at least 6 months after the last transplantation (average follow-up period from the time of primary transplantation 89.5 months).
Results: Twenty-nine eyes (34%, n=28) developed secondary glaucoma. Thirty-nine of the 122 repeated corneal grafts (32%) were affected. The following types of glaucoma were disclosed: closed-angle (55%), corticosteroid-induced (14%), vitreous in angle (11%), angle recession (3%), aqueous misdirection (3%) and unknown (14%). Surgical intervention was required in 62%. The glaucoma was controlled in 12 eyes (41%), of which 5 (17%) had clear regrafts. In 16 eyes (55%), regrafts failed due to uncontrolled glaucoma and in 8 (28%) due to causes other than glaucoma. Visual acuity was 20/30-20/200 in 17%, counting fingers at <20 feet in 31%, hand movement/ light perception in 35% and no light perception in 17%.
Conclusions: Secondary glaucoma in repeated corneal transplantation was associated with poor visual outcome. The glaucoma was usually unstable posing difficulties in establishing permanent anti-glaucoma therapy and its long-term course often results in regraft failure.
Commercial relationship: None