Abstract

P 014

Architecture of anterior chamber and intraocular eye pressure after penetrating keratoplasty in patients with keratoconus

Benjamin Mauer1, Zisis Gatzioufas1, Ursula Löw1, Nikolaos Kozeis2, Frank Schirra1, Berthold Seitz1
1Klinik für Augenheilkunde, Universitätskliniken des Saarlandes, Homburg/Saar, 2Abteilung für Kinderophthalmologie, Augenklinik, Hippokration Krankenhaus, Thessaloniki, Griechenland

Objective
To investigate the association between the anterior chamber geometry and the intraocular eye pressure (IOP) after penetrating keratoplasty (pKPL) in patients with keratoconus.
Methods
Twenty patients with keratoconus (14 men, 6 women), who were subjected to pKPL, were examined with the aid of Pentacam preoperatively as well as 1 week postoperatively. Maximal anterior chamber depth (mACD) and well as anterior chamber angle (ACA) at 0° and 90° were evaluated. IOP was measured with the aid of Goldmann-Tonometry and Dresden-correction for corneal thickness was performed.
Results
IOP at first postoperative day was significantly increased (20,1 ± 3,7 mmHg) compared to the preoperative IOP (10,7 ± 2,3 mmHg) (t-test, p<0,001). Pentacam examination revealed a significant reduction of postoperative ACA both at 0° (28,7 ± 4,3 degrees) and 90° (27,8 ± 5,2 degrees) compared to preoperative ACA (37,5 ± 5,4 degrees at 0° and 38,3 ± 3,7 degrees at 90°) (t-test, p1<0,05, p2<0,05). Postoperative mACD (3,1 ± 0,2 mm) was significantly reduced compared to preoperative mACD (3,7 ± 0,3 mm) (t-test, p<0,05). Regression analysis documented a significant correlation between the reduction of ACA and the IOP increase postoperatively (Pearson correlation, r= -0.78, p<0.05).
Conclusions
Several studies have reported a temporary increase of IOP after pKPL. It has been hypothesized that trabeculitis and development of anterior synechiae due to the chirurgical manipulations may contribute to this elevation of IOP. Our results suggest that narrowing of the anterior chamber angle may also be a factor leading to increased IOP after pKPL in patients with keratoconus.

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