Abstract
To evaluate the complications, and visual and graft survival outcomes in eyes that had undergone penetrating keratoplasty (PKP) for keratoconus. This restrospective study includes 311 patients with keratoconus who had undergone PKP between January 1, 2001, and December 31, 2002, at King Khaled Eye Specialist Hospital. All patients were followed up postoperatively (maximum follow-up, 65.77 months). The mean age of patients with keratoconus at transplantation was 23.72 years. A preoperative best spectacle-corrected visual acuity (BSCVA) OF 20/40 or better was achieved in 13 eyes (4.2%). At a mean follow-up of 27 months, 212 eyes (68.2%) achieved a BSCVA of 20/40 or better. Postoperative visual acuity was significantly associated with preoperative visual acuity (P < 0.00). Only 6 eyes (1.9%) experienced graft failure, with a mean follow-up of 23.62 months. The graft rejection rate (6.8%) was a significant risk factor for failure (P = 0.00). Age, gender, corneal graft diameter, and intraoperative vitreous loss had no statistically significant effects on the PKP outcome (P> 0.05). Kaplan-Meier analysis revealed that the probabilities of graft survival were 99.8% at 1 year and 97.6% at 5 years after transplantation. Performing PKP in eyes with keratoconus is associated with good visual results and an excellent graft outcome.
Highlights
In keratoconus, the cornea progressively thins and steepens, leading to the development of myopia and irregular astigmatism and, eventually, to the loss of best spectacle-corrected visual acuity (BSCVA); this noninflammatory ecstatic corneal disorder occurs naturally and is characterized as bilateral but asymmetrical. [1] Various therapeutic modalities for this disorder exist, including spectacles, contact lenses, lamellar keratoplasty (LK), penetrating keratoplasty (PKP), and, recently, intracorneal rings (ICRs). [1, 2] The type of treatment chosen depends on the severity of the disorder
In patients with keratoconus who have contact lens failure or apical scarring, PKP is a well-accepted treatment. [2, 3] Previous researches have revealed that keratoconus is one of the leading indications for corneal transplantation in Saudi Arabia and throughout the world. [3, 13] The purpose of this retrospective study is to determine the outcomes of a series of consecutive PKPs performed for patients with keratoconus at King Kahled Eye Specialist Hospital in Riyadh, Saudi Arabia
At the time of PKP, concomitant cataract extraction and intraocular lens (IOL) implantation were performed on only 1 patient; planned surgical iridotomy was performed on 2 patients
Summary
The cornea progressively thins and steepens, leading to the development of myopia and irregular astigmatism and, eventually, to the loss of best spectacle-corrected visual acuity (BSCVA); this noninflammatory ecstatic corneal disorder occurs naturally and is characterized as bilateral but asymmetrical. [1] Various therapeutic modalities for this disorder exist, including spectacles, contact lenses, lamellar keratoplasty (LK), penetrating keratoplasty (PKP), and, recently, intracorneal rings (ICRs). [1, 2] The type of treatment chosen depends on the severity of the disorder. The cornea progressively thins and steepens, leading to the development of myopia and irregular astigmatism and, eventually, to the loss of best spectacle-corrected visual acuity (BSCVA); this noninflammatory ecstatic corneal disorder occurs naturally and is characterized as bilateral but asymmetrical. In patients with keratoconus who have contact lens failure or apical scarring, PKP is a well-accepted treatment. [2, 3] Previous researches have revealed that keratoconus is one of the leading indications for corneal transplantation in Saudi Arabia and throughout the world. [3, 13] The purpose of this retrospective study is to determine the outcomes of a series of consecutive PKPs performed for patients with keratoconus at King Kahled Eye Specialist Hospital in Riyadh, Saudi Arabia In patients with keratoconus who have contact lens failure or apical scarring, PKP is a well-accepted treatment. [2, 3] Previous researches have revealed that keratoconus is one of the leading indications for corneal transplantation in Saudi Arabia and throughout the world. [3, 13] The purpose of this retrospective study is to determine the outcomes of a series of consecutive PKPs performed for patients with keratoconus at King Kahled Eye Specialist Hospital in Riyadh, Saudi Arabia
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