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The investigators labeled pre-existing glaucoma, high preoperative intraocular pressure, and combined keratoplasty with removal or exchange of an intraocular lens were definitely associated with an increased risk.
New research shows several identifiable risk factors associated with ocular hypertension after keratoplasty.
A team led by Ilona Liesenborghs, PhD, University Eye Clinic Maastricht, identified the risk factors for the development of ocular hypertension following keratoplasty.
In the systemic review, the investigators identified 67 relevant published articles after searching through databases for studies on an intraocular pressure increase above 21 mmHg at 6 months or a threshold or timepoint close to that and reported whether the preoperative or intra operative status of risk factors.
The team presented the results in evidence tables, visualizing the direction of the association, whether univariate and/or multivariate analysis was performed, and the significance level.
Next, 4 researchers, blinded for the risk factors, independently assigned a level of evidence as either definitely, probably, possibly, or not associated, with consensus being met during the group meeting.
Overall, there were 110 studied risk factors.
From here the investigators labeled pre-existing glaucoma, high preoperative intraocular pressure (IOP), and combined keratoplasty with removal or exchange of an intraocular lens (IOL) were definitely associated with an increased risk.
They also found if the pre-or postoperative lens status was undefined, aphakia and pseudophakia with the IOL in the anterior or posterior chamber were also definitely associated with an increased risk when compared to phakia.
There were several risk factors that were labeled probably associated, including glaucoma in the contralateral eye, indication of bullous keratopathy, African American descent, preoperative treatment with cyclosporine or olopatadine 0.1%, postoperative treatment with prednisolone acetate 1%, and combined surgery in general.
The remained of potential risk factors lacked sufficient evidence to make a call and require further investigations.
“Risk factors with a definite association can help clinicians select patients at risk and adjust their follow-up and treatment,” the authors wrote. “The other factors need further investigation.”
The study, “A systematic review for the identification of risk factors for the development of ocular hypertension after keratoplasty,” was published online by Netherlands Ophthalmological Society (NOG) Annual Congress