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Majed Alkharashi,1 Halla A AlAbdulhadi,2 Wael Otaif,1 Adel Salah Alahmadi,3,4 Bader Alanazi,5 Ahmed Al Habash,6 Ahmed Aldayel,2 Mohanna Aljindan,6 Abdulmohsen Almulhim,5 Halah Bin Helayel2 1Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Anterior Segment Division, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia; 3Vitreoretinal Division, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia; 4Department of Ophthalmology, MOH, Madinah, Saudi Arabia; 5Department of Ophthalmology, College of Medicine, Jouf University, Sakakah, Saudi Arabia; 6Department of Ophthalmology, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Wael Otaif, Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia, Tel +966 549778998, Email Waelotaif@gmail.comAbstract: Positive vitreous pressure (PVP) is common during open anterior segment surgery and penetrating keratoplasty (PKP) has a reported incidence rate of 40– 50%. Despite adequate perioperative preventive precautions, positive pressure occurs during surgery and optimum management of PVP is required to avoid serious complications. Many pharmacological and mechanical approaches can be employed either preoperatively or intraoperatively to decrease vitreous pressure. Surgical techniques such as graft-over-host technique, the modified graft-over-host technique, techniques employed mattress sutures and needle, or Vitreous aspiration or vitrectomy can be effectively used to manage intraoperative PVP during PPK. This article reviews the incidence, risk factors, prevention, and different approaches to the management of positive vitreous pressure during PKP to analyze the available evidence in order to improve the safety profile of PKP and prevent sight-threatening complications.Keywords: positive vitreous pressure, penetrating keratoplasty, complications, management, prevention |
