Penetrating keratoplasty outcome trends in a tertiary referral hospital, 2012-2019
First Author: S.Montolio Marzo SPAIN
Co Author(s): M. Roig-Revert E. Fernández-López J. Piá-Ludeña G. Rodriguez-Iranzo C. Peris-Martínez
Describe trends in penetrating keratoplasty (PK) in a tertiary hospital between 2012 and 2019.
FISABIO Oftalmología Médica (Valencia, Spain).
Retrospective review of the patients undergoing PK between 2012-2019. We include 222 eyes and 393 surgeries. PK remains as the most common keratoplasty in our hospital, accounting 62% of the total number of keratoplasties. Three surgeons performed 113 (51,1%), 86 (38,9%) and 12 (5,4%) PK respectively. The most common diagnosis prior to PK was edema after cataract surgery, followed by bullous keratopathy, Fuchs dystrophy and leucoma.
206 eyes (49%) underwent reintervention, mainly regrafting followed by suture adjustment and amniotic membrane implantation. Reintervention ratio was higher (p<0,007) after perforation. 78 (34,9%) needed another graft. Keratoconus had the lowest regraft rate, whereas perforation required the highest (p=0,009). 22 patients showed glaucoma, 4 had drainage surgery, 1 non-penetrating deep sclerectomy and 9 had cyclodiode. 66 (25%) patients required 1 drug and 101 (38%) required 2 drugs for glaucoma. 68 (30%) eyes suffered graft failure. Failure rate was higher after perforation. Rejection appeared in 22 (10%) patients. Most common complications were elevated intraocular pressure (9,9%) and infectious keratitis (10,3%).
penetrating keratoplasty remains as the most common keratoplasty in our hospital despite the introduction and improvement of lamellar techniques over the last decade. Outcome is similar to published previously showing consistent reduced rejection rate and poorer visual acuity than usual. Vision improved in 93 (42%), was maintained in 31 (13,96%) and declined in 93 (41,89%) eyes. As a referral hospital we receive the most complex cases, which may bias our sample.