Penetrating Keratoplasty for Bullous Keratopathy after Argon Laser Iridotomy

Abstract

Recently, bullous keratopathy has been reported as a devastating late-onset complication after argon laser-iridotomy (ALI). This study investigated the results of penetrating keratoplasty for bullous keratopathy after ALI.

In this study, 17 patients (17 eyes) who had undergone penetrating keratoplasty between April, 1992 and August, 1995 were retrospectively evaluated. The mean age was 73.2 years, with a range of 63 to 85 years. Five eyes received ALI for primary angle-closure glaucoma attack and 12 eyes for prophylaxis. Five eyes with Fuchs’ endothelial dystrophy were included in this study. The triple procedure, consisting of penetrating keratoplasty with cataract extraction and intraocular lens implantation was performed in 11 eyes. The average postoperative follow-up was 1.5 ± 0.1 years. All grafts were clear at the latest examination. Corrected visual acuity improved in 16 (94.1%) of the 17 eyes. Notable complications were transient shallow anterior chambers (three eyes) in the early postoperative period and anterior chamber fibrin response (eight eyes) at the postoperative period. Although penetrating keratoplasty was successful in bullous keratopathy after ALI, anterior chamber fibrin response was observed at high incidence. The presurgical systemic administration of corticosteroid may be effective.