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Corneal transplantations at the 1st Department of Ophthalmology, AHEPA University Hospital during the period September 2011 to September 2015: an audit

Poster Details

First Author: N. Ziakas GREECE

Co Author(s):    D. Kapantais   A. Lioura   D. Nanas   K. Marinopoulos   A. Chranioti   P. Oikonomidis

Abstract Details

Purpose:

To report the leading indications, techniques, complications and visual outcomes of corneal transplantations from November 2011 to March 2015.

Setting:

1st Department of Ophthalmology, AHEPA University Hospital.

Methods:

Retrospective data of 221 corneal transplantations performed at AHEPA University Hospital were reviewed. Indications were classified into nine different groups: Pseudophakic bullous keratopathy, ectasias (keratoconus, keratoglobus), previous graft rejection, Fuchs’ keratopathy, corneal scar (post-traumatic or chemical), microbial keratitis (bacterial and fungal), herpetic keratopathy, corneal dystrophy and other.

Results:

The leading indications for corneal transplantations, in order of decreasing frequency were: Pseudophakic bullous keratopathy (n=60 [27.15%]), ectasias (n=51 [23.08%]), previous graft rejection (n=38 [17.19%]), Fuchs’ keratopathy (n=24 [10.86%]), corneal scar (n=17 [7.69%]), microbial keratitis (n=14 [6.33%]), herpetic keratopathy (n=9 [4.07%]), corneal dystrophy (n=4 [1.8%]) and other (n=8 [3.62%]). Regarding the techniques used, the most preferred technique remains penetrating keratoplasty (PK) (n=180 [81.45%]) followed by Descemet's stripping endothelial keratoplasty (DSAEK-DSEK) (n=31 [14.03%]), Descemet's membrane endothelial keratoplasty (DMEK) (n=5 [2.26%]) and Deep anterior lamellar keratoplasty (DALK) (n=5 [2.26%]). Mean best-corrected visual acuity (BCVA) was 1/10 preoperatively and improved to 2.6/10 post-operatively with an average follow-up of 19.17 months. The most common complications were: Graft rejection (n=18 [8.14%]), graft failure (n=12 [5.42%]), partially detached graft (n=5 [2.26%]), glaucoma (n=5 [2.26%]), persistent epithelial defect (n=5 [2.26%]), neovascularization (n=3 [1.36%]), herpetic recurrence (n=2 [0.90%]) and other (n=7 [3.17%]).

Conclusions:

Pseudophakic bullous keratopathy still remains the leading indication for corneal transplantation. Ectasias, previous graft rejection and Fuchs’ keratopathy have also remained consistent indications for keratoplasty during the last 4 years. Concerning the novel techniques introduced to the field of corneal surgery, DSEK-DSAEK increased from zero percent in 2010 to 14.03%, while DMEK and DALK increased from zero percent to 2.26%. As far as the visual outcome is concerned, the patients gained a mean of 8 letters on the Snellen chart at a mean follow-up of 19.17 months. Complications were noted in the 25.33% of keratoplasties with graft rejection and graft failure being the commonest. FINANCIAL DISCLOUSRE: NONE

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