A recent retrospective review found that endothelial keratoplasty patients had lower IOP and took fewer steroids compared with penetrating keratoplasty (PKP) patients over a two-year follow-up period.

The study included 239 eyes that underwent PKP (n=127), Descemet’s membrane endothelial keratoplasty (DMEK) (n=46) or Descemet’s stripping endothelial keratoplasty (DSEK) (n=66).

The researchers reported higher post-op IOP in PKP patients, averaging 15.9mm Hg at 24 months for PKP vs. 13.8mm Hg in DMEK and 13.4mm Hg DSEK patients. They did not note any significant differences in IOP at any point during the two years following DMEK and DSEK. Additionally, PKP patients needed more steroids at months three, six, 12 and 24.

DSEK eyes required the most IOP-lowering drops of the three groups. These eyes also required more IOP-lowering medications compared with DMEK eyes at months three and 12. Approximately 6% to 7% of the total patients required glaucoma surgery at two years.

“Our study illustrates that endothelial keratoplasties when compared with full-thickness PKPs provide the benefit of lower IOP and decreased topical steroid need at most postoperative timepoints up to a two-year follow-up,” the researchers concluded in their paper.

Vu PQ, Aggarwal S, Lu Y, et al. Comparison of intraocular pressure, usage of topical steroids, need for intraocular pressure lowering drops, and incidence of glaucoma surgery up to 2 years after penetrating keratoplasty and endothelial keratoplasty. J Glaucoma. 2020;29:1120-5.