A Comparison Of Endothelial And Penetrating Keratoplasty In Patients With Iridocorneal Endothelial Syndrome: A Registry Study

Published 2023 - 41st Congress of the ESCRS

Reference: FP10.10 | Type: Free paper | DOI: 10.82333/9tmt-7w64

Authors: Philipp Roberts* ¹ , Miriam Keane ² , Gink Yang ³ , Elsie Chan ⁴ , Damien Harkin ⁵ , Natalie McKirdy ⁵ , Mark Daniell ⁴

¹Ophthalmology,Medical University of Vienna,Vienna,Austria, ²Ophthalmology,Flinders University,Adelaide,Australia, ³Centre for Eye Resarch Australia,Melbourne,Australia, ⁴Ophthalmology,Royal Victorian Eye and Ear Hospital,Melbourne,Australia, ⁵Centre for Vision and Eye Research,Queensland University of Technology,Brisbane,Australia

Purpose

To compare graft survival of endothelial keratoplasty (EK) versus penetrating keratoplasty (PK) in patients with iridocorneal endothelial (ICE) syndrome and identify ocular features associated with graft survival.

Setting

Observational, prospective cohort study

Methods

A total of 30,806 first grafts performed between 1985 and 2020 were identified through the Australian Corneal Graft Registry and included in the study. 196 eyes underwent a primary corneal graft for ICE syndrome. Kaplan-Meier graft survival plots and Chi-squared tests were performed to identify graft survival rates for EK and PK. A history of raised intraocular pressure (IOP) was recorded and analysed. Additionally, graft survival of eyes with ICE syndrome were compared to that of other indications.

Results

Grafts performed for ICE syndrome increased from 0.5% between 1985 to 2004 to 0.8% of all cases during the 2005 to 2020 period (Chi square=9.35, p=0.002). From 2010, EK surpassed PK as the preferred graft type. Survival of primary grafts in eyes with ICE syndrome was lower than for other indications (Chi square=56.62, p<0.001). Graft survival was higher following PK than Descemet stripping (automated) endothelial keratoplasty (DS(A)EK) (Chi square=10.56, p=0.001). Graft survival was higher in eyes without a history of raised IOP compared to those with a reported history of raised IOP (Chi square=13.06, p<0.001).

Conclusions

ICE syndrome carries a poor prognosis for graft survival. DS(A)EK had a poorer prognosis than PK. A history of raised IOP is associated with higher risk of graft failure.