Glaucoma following Corneal Transplant Surgery

Post-PK glaucoma is an important cause for irreversible visual loss and graft failure after penetrating keratoplasty. The etiology for this disorder is multifactorial and with the use of new diagnostic equipment it is now possible to elucidate the exact pathophysiology of this condition. A clear understanding of the various mechanisms which operate during different time frames following keratoplasty is essential to chalk out the appropriate management algorithms. The various issues with regard to its management, including the putative risk factors, IOP assessment post-PK, difficulties in monitoring with regard to the glaucoma visual fields and optic nerve evaluation are discussed. A stepwise approach to management starting from the medical management to surgery with and without metabolites and the various cycloablative procedures in cases of failed filtering procedures and excessive perilimbal scarring is presented.