Long-term outcomes of penetrating keratoplasty in keratoconus: analysis of the factors associated with final visual acuities
First Author: Man SooKim SOUTH KOREA
Co Author(s): Jin A Choi Kyung Sook Cho
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To investigate the long-term results of penetrating keratoplasty (PK) in patients with keratoconus (KC) and to evaluate factors that might influence the final visual outcome.
: St. Mary's hospital, Catholic University of Korea, Seoul, South Korea
We retrospectively reviewed the data of all patients with clinical KC who had undergone PK by a single corneal surgeon in a single center from May 1980 to December 2005. The age of the patients, preoperative best-corrected visual acuity (BCVA), corneal thickness, death to preservation time, and preservation to transplantation time were recorded. Additionally, postoperative complications such as graft rejection, development of glaucoma and specular microscopy were checked during the follow-up.
Sixty-nine eyes from 69 patients were finally included. The follow-up period was 8.64±6.13 years. Graft rejection occurred in 4 eyes of 69 cases (5.8%), and the time to graft rejection was 2.1±1.3 years. A Kaplan–Meier survival analysis showed that the estimated cumulative probability of graft rejection at 6, 13, and 17 years after PK were 95.6%, 90.0%, and 78.8%, respectively. When we evaluated factors that might influence final BCVA in eyes, no disparity donor-host trephine size (same graft size) as well as higher spherical equivalent, and average K-valuewereassociatedwithhigherfinalBCVA.(p=0.006,0.051,0.092,and0.021ineyeswithfollow-up<8years;p=0.068,0.065,and0.030ineyeswithfollow-up≥8years, respectively).
The long-term results of PK in patients with KC were favorable with a high percentage of good BCVA. Less myopic change and low average K-reading, as well as a surgical technique using the same size donor-recipient button may provide better visual outcomes particularly in patients with KC. FINANCIAL INTEREST: NONE