Assessment and evaluation of visual acuity, indications, and complications after penetrating keratoplasty

Abstract

ObjectiveThe aim of the study was to assess and evaluate the indications of penetrating keratoplasty (PKP), visual outcome, complications, and causes of suboptimal visual acuity after PKP.BackgroundPKP involves surgical removal of diseased or damaged cornea from the host and replacement with a full-thickness donor cornea.Patients and methodsPKP alone or triple procedure (PKP combined with extracapsular cataract extraction and intraocular lens implantation) was performed in 50 eyes of 50 patients at National Eye Center Hospital, Cairo, Egypt, between 1 January 2009 and 31 December 2011. The outcome was evaluated in terms of graft survival (number of clear grafts at final follow-up) and final best-corrected visual acuity.ResultsOf 50 patients who underwent PKP, 66% were male patients and 34% were female patients. The mean recipient age was 36.5 years (range 9-78 years). Leading indication of PKP was keratoconus (36%). PKP alone was performed in 88% patients, and 12% patients underwent triple procedure. Follow-up period after surgery was on the first postoperative day and after 1 week, 1 month, and 3 months. Overall graft survival was 86%. Excluding failed grafts, final best-corrected visual acuity achieved was 0.5 or better in 4% patients, 0.3-0.16 in 54% patients, 0.1-0.016 in 28% patients, and less than counting fingers (CF) in 14% patients. Keratoconus had most favorable outcome with graft survival of 94.4% and final visual acuity of 0.16 or better in 83.3% patients. Graft survival and final best-corrected visual acuity of 0.16 or better were found in remaining indications: corneal scar due to trauma (90 and 40%), corneal scar due to infection (66.7 and 44.4%), corneal dystrophy (100 and 71.4%), and other indications (66.7 and 16.7%).ConclusionThis series showed that PKP is an effective procedure for corneal disease with poor vision. Visual outcome was good especially in cases of keratoconus.