Penetrating corneal transplant (PKP) surgery has been performed for centuries as the procedure of choice to restore vision in cases of advanced
corneal disease. However, the last two decades have seen the introduction of lamellar corneal surgery (deep anterior
lamellar keratoplasty, DALK; Descemet stripping-automated endothelial
keratoplasty, DSAEK; and Descemet membrane endothelial
keratoplasty, DMEK) which has shown several advantages over PKP and has rapidly gained popularity, given its benefits.
Glaucoma after corneal graft surgery is an important cause of visual loss and graft failure. The main risk factors for developing
glaucoma after any type of corneal graft are
steroid-related intraocular
hypertension and pre-existing
glaucoma. The incidence of
glaucoma after corneal graft surgery varies according to the specific risk factors and the type of corneal graft performed. One major advantage of modern layer selective
lamellar keratoplasty is the reduced risk of
glaucoma compared with PKP. This reduced
glaucoma risk after corneal lamellar graft surgery is mainly due to the less destructive surgical nature of the lamellar procedures and also the reduced use of postoperative
steroid treatment.
Glaucoma can complicate not only
corneal transplantation but has also been observed following other anterior segment procedures from
laser refractive surgery to keratoprosthesis. The aim of this chapter is to describe the incidence, etiology, and management of
glaucoma after corneal transplant and some common corneal
surgical procedures.