Glaucoma after penetrating keratoplasty: Risk factors and its management

Glaucoma is the second leading cause of graft failure after penetrating keratoplasty. Prompt diagnosis and aggressive management is mandatory to salvage the graft. Indications of penetrating keratoplasty, lens status, additional procedures with penetrating keratoplasty, preexisting glaucoma and re-graft are the main risk factors for glaucoma after penetrating keratoplasty. Various newer modalities like recent tonopens, ultrasound biomicroscopy, and anterior segment optic coherence tomography are helpful tools for its diagnosis. Various newer drugs, surgical modifications such as trabeculectomy with antimetabolites like mitomycin-C and 5 fluorouracil, glaucoma drainage devices, cyclodestructive procedures have added the chances of success of its management, but still graft failure secondary to glaucoma is very common.

Keywords: Trabeculectomy, Glaucoma drainage device, Graft failure.