To assess the risk factors proceeding to graft failure in post-keratoplasty ocular hypertension patients.

In 35 eyes diagnosed with post-keratoplasty ocular hypertension (graft failure: 13 eyes; graft survival: 22 eyes), relationships between graft status at the observation time and pre-keratoplasty diagnosis, lens status, history of graft failure, donor size, difference between donor and recipient graft size, donor corneal endothelial cell count, post-keratoplasty intraocular pressure (after 1 week and maintenance intraocular pressure after surgery), and number of antiglaucomatic agents were investigated. The relative risks of each factor to induce graft failure were also evaluated.

Previous graft failure history, pre-existing pseudophakic bullous keratopathy and aphakia/pseudophakia showed statistically significant high probabilities of proceeding to graft failure ( p < 0.05). In particular, the intraocular pressure 1 week after the graft was statistically higher ( p < 0.05) in the graft failure group (24.31 ± 8.82 mm Hg) than in the graft survival group (16.81 ± 6.69 mm Hg).

Strict management of intraocular pressure in the early phase of penetrating keratoplasty could contribute to reducing graft failure in post-keratoplasty ocular hypertension patients.