Factors Associated With Failure In Patients After Penetrating Keratoplasty At The National Ophthalmology Unit (Uno). Guatemala City, Guatemala.

To describe the factors associated with failure in patients after penetrating keratoplasty at the National Ophthalmology Unit during 2023.

Data storage, processing and analysis were carried out in a computerized manner by creating a database in Microsoft Office Excel 2016 Operating System, according to the statistical package. The results were expressed by frequency distribution in tables for better understanding and analysis.

A descriptive, retrospective study was conducted on 36 patients who underwent penetrating keratoplasty who were operated on by heads and fellows of the Anterior Segment Service of the National Ophthalmology Unit of Guatemala, in the period from January to November 2023. The research universe was made up entirely of patients who underwent penetrating keratoplasty. 
The analysis of the follow-up and evolution of these patients was carried out by reviewing physical records in the Clinical Archive section and virtual records in the SALUS System. 

Of the 36 patients studied, 16 were female, representing 44.44%, and 20 were male, representing 55.56%. Of these, 36.11% were patients under 18 years of age, regardless of sex. The average age was 36.27 years with a standard deviation of 23.98. 
The predominant diagnosis in patients who underwent penetrating keratoplasty was, firstly, corneal ulcer, with 30.56%, followed by bullous keratopathy, representing 19.44% of the total. The third diagnosis in order of frequency was keratoconus, with 16.66%. 
22.22% of the patients who underwent penetrating keratoplasty had failure, 37.5% of these had previously undergone the same procedure and had presented endothelial failure.

In the studied population, the most important risk factors related to the development of corneal failure are: male sex, over 18 years of age, surgical-ophthalmological history of penetrating keratoplasty in the same eye, preoperative diagnosis of corneal ulcer regardless of the origin and bullous keratopathy; in addition, the use of a trephine in the recipient cornea with a diameter >8.0 mm.