Fixed Dilated Pupil After Penetrating Keratoplaty for Macular Corneal Dytrophy and Keratoconu

Purpoe To identify predipoed eye, rik factor, and protective meaure and to evaluate method of treatment for fixed dilated pupil after penetrating keratoplaty (PKP) for macular corneal dytrophy (MCD) and keratoconu. Deign Retropective obervational cae erie. Method A retropective review wa conducted of the chart of 195 patient who had PKP for MCD and of 1800 patient who had PKP for keratoconu at the King Khaled Eye pecialit Hopital in Riyadh, audi Arabia. The review included an evaluation of the preoperative and intraoperative data and the potoperative coure. In addition, clinical examination at the lat viit and photograph of the cornea, pupil, iri, and len were analyzed. Reult Twenty-one eye of 18 patient had fixed dilated pupil after PKP; 15 eye of 12 patient had MCD, and ix eye of ix patient had keratoconu. A rie in intraocular preure (IOP) during the procedure wa een in five patient (23.8%). Fixed dilated pupil wa documented on the firt and econd potoperative day and the econd potoperative week in 17 (80.9%), one (4.8%), and three (14.3%) eye, repectively. ix eye (28.6%) of ix patient had evere eye inflammation. Only one eye (4.8%) regained partial reactivity of the pupil on follow-up viit. even eye (33.3%) experienced len change; nine eye (42.8%) had elevated IOP on the firt potoperative day, and none of the eye had chronic glaucoma. Concluion Inflammatory and multifactorial pathologic condition can caue fixed pupil after PKP. Atropine ue, keratoconu, and high IOP are not contant finding in thi yndrome. Awarene of the rik factor of fixed dilated pupil will help prevent againt it occurrence.