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继发性青光眼是穿透角膜移植术(PKP)后一种严重的并发症,常导致植片混浊,患者视力不可逆下降。PKP术后继发青光眼的预防及处理极为重要,包括PKP的术前准备、术后眼压监测以及对术后高眼压的及时处理。针对大植片PKP术后青光眼的高发生率,一些改良术式正在应用,如大植片深板层角膜移植术、板层角巩膜联合部分穿透角膜移植术、桥式穿透角膜移植术、改良的角巩膜移植术等。对上述改良术式、继发性青光眼的药物和手术方式的选用进行综述。
Secondary glaucoma is a serious complication after penetrating keratoplasty (PKP) and often results in opacification of the grafts, with an irreversible decline in visual acuity. Prevention and management of postoperative PKP secondary glaucoma is extremely important, including PKP preoperative preparation, postoperative IOP monitoring, and postoperative intraocular pressure and timely treatment. In view of the high incidence of glaucoma after major implant PKP, some modified techniques are being applied, such as deep parenchyma keratoplasty, lamellar keratoconjunctival partial penetrating keratoplasty, bridge penetrating keratoplasty, modified Scleral transplantation and so on. The above-mentioned modified surgery, secondary glaucoma medication and surgical options are reviewed.