Indications and graft survival analysis in optical penetrating keratoplasty in a tertiary care center in North India: a 5-year study

Arya, Shalini S.; Raj, Amit; Bamotra, Ravi Kant; Bhatti, Anubha; Deswal, Jyoti; Sindhu, Meenakshi

doi:10.1007/s10792-017-0641-0

Cited by 9 publications

(7 citation statements)

References 20 publications

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“…Pan et al (2012) (in China) and Omar et al(2013) (in Saudi Arabia) had studied outcome of optical PK collectively for various indications (bullous keratopathy, keratoconus, herpetic / non-herpetic scar, regraft, and dystrophies) and mentioned three-year graft clarity of 65.1% and 90.7% respectively. Graft survival in their study was better than ours because keratoconus, dystrophy, degenerations or bullous keratopathy have better prognosis than other indications (Barraquer et al, 2019;Arya et al, 2018;Joshi et al, 2012 ). Arya et al (2018) mentioned graft clarity of 62.5% in non-herpetic scar and 55.6% in herpetic scar; they showed better graft clarity with bullous keratopathy (73.3%) and corneal dystrophy/degeneration (84.6%).…”

Section: Discussionmentioning

confidence: 47%

“…Keratoplasty is the surgical procedure for treatment of significant viral or microbial corneal scars. Corneal scars do not have as good graft survival rate as compared to keratoconus, corneal dystrophies, and degenerations; vascularized herpetic corneal scars may have even less graft survival rates ( Barraquer et al, 2019;Arya et al, 2018;Joshi et al, 2012). Our previous report shows that in our country, 41% of keratoplasties are performed for active corneal infection and 26.8% for corneal scars, half of which were due to healed infective keratitis (Bajracharya et al, 2013).…”

Section: Introductionmentioning

confidence: 76%

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Outcome of Optical Keratoplasty for Corneal Scar due to Infective Keratitis

Bajracharya

2023

Nep J Oph

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Introduction: Corneal opacity is an important cause of blindness in developing countries. Objectives: This study analyzes optical keratoplasty performed for corneal opacity due to infective keratitis. Materials and methods: This is a retrospective study of all consecutive cases of optical keratoplasty performed between 2011 and 2014 (four-year period) for healed infective keratitis. Cases with less than two months’ followup were excluded during outcome evaluation. Comparison was made between keratoplasty for Microbial and Viral (herpetic) Scar. Results: Ninety-three eyes of 93 patients were enrolled. Fifty-nine (63.4%) were male. Average age of patients was 38.9±19.5 years. Average donor endothelial cell count was 2713±434.5 cells/mm2. Fifty-four (58%) corneal scars were due to microbial keratitis and others were herpetic. Eighty-five (91.4%) had undergone penetrating keratoplasty. Eighty-eight (94.6%) cases were included for outcome analysis. Average follow-up duration was 37±27.5 months. Fifty-two (59%) had clear graft at their last visit. Twenty-three (26.1%) grafts had endothelial failure and 13 (14.7%) grafts failed due to late onset keratitis. Twenty-five (28.4%) had vision of ≥6/18. Rejection occurred in 24(27.2%) and glaucoma in 11(12.5%). Post-operatively viral keratitis in the graft occurred significantly more inViral Scar Group (38.6%, n=15) than in Microbial Scar Group (5.5%, n=3). But there was no significant difference in graft clarity, rejection, vision and secondary glaucoma between the two Groups. Conclusion: Outcome of keratoplasty for post-infectious scars was found fairly satisfactory. Although occurrence of viral keratitis was higher in case of keratoplasty done for Viral Scars, the final result was similar to that of microbial scar.

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Section: Discussionmentioning

confidence: 47%

Section: Introductionmentioning

confidence: 76%

Outcome of Optical Keratoplasty for Corneal Scar due to Infective Keratitis

Bajracharya

2023

Nep J Oph

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“…Indications are predictors of graft outcome, and it is of concern that more than 80% of keratoplasty procedures were performed in eyes with poor or moderate outcomes. In India, the long-term graft survival rate is poor,[ 38 ] and far less than other advanced healthcare systems in Asia or other parts of the world. Therefore, keratoplasty can only be a part of the solution in reducing corneal blindness in India.…”

Section: Discussionmentioning

confidence: 99%

Trends in keratoplasty from central and Northern India. Part I: Indications for keratoplasty

Parmar,

Chatterjee,

Kapur

et al. 2023

Indian Journal of Ophthalmology

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Purpose: To report the indications for keratoplasty and analyze trends in two decades in India. Methods: This was a retrospective review of eye bank registries of six tertiary eye care centers located in central and northern India from 2005 to 2021. The patterns of corneal pathology and changes in trends were analyzed. Results: Between 2005 and 2021, 13223 corneal grafts were performed in the six collaborating tertiary eye care centers. The most common indication for keratoplasty in both decades was corneal ulcer (41.1%), followed by corneal scar (25.5%), failed graft (12.0%), post-cataract surgery corneal edema (11.7%), corneal dystrophies (3.1%), corneal ectasia (1.8%), corneal trauma (0.3%), congenital corneal opacity (0.3%), and others (4.1%). An increasing trend was seen in corneal ulcers, failed grafts, and keratoconus. A reducing trend was seen in corneal scar and aphakic bullous keratopathy. There was no change in pseudophakic bullous keratopathy and Fuchs endothelial corneal dystrophy. Conclusion: Corneal ulcers, corneal scars, failed grafts, and post-cataract surgery corneal edema remained the foremost indications for keratoplasty in two decades in India. An increasing trend was seen in corneal ulcers and failed grafts which are of concern as these indications carry a poorer outcome. Capacity building in lamellar keratoplasty techniques is the need of the hour as pseudophakic bullous keratopathy was an important indication, and an increasing trend was noticed in keratoconus.

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“…The outcome of optical penetrating keratoplasty in various parts of India has reported a survival rate of 65%–67% at one year, which is similar to our study. [ 17 18 ]…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of corneal tissue harvested from organophosphorous deceased patients

Sarangi

Sahu

Priyadarshini

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To analyze the quality of tissues and outcome of corneal transplants from tissues harvested from the donors of organophosphorus poisoning victims. Methods: A retrospective study was carried out on corneas harvested from organophosphorus poisoning victims between January 2016 and December 2018. Details of quality of tissues and outcome following keratoplasty were collected from the eye bank and outpatient records, respectively. Results: Four hundred and seventy-eight donor corneas were collected from the victims of organophosphorus poisoning during the study period. The mean age of the donor was 38.8 ± 16.5 years. The mean donor-to-preservation time was 6.2 ± 3.2 hours. The mean endothelial cell density on specular microscopy was 2986.5 ± 369.0 cells/mm 2 . Four hundred and twenty-two (88.2%) donor corneas were utilized. Of the 121 corneas utilized at our institute for transplantation, 73 and 48 corneas were for optical and therapeutic/tectonic indications, respectively. Of the 73 optical grafts, 25 patients were lost-to-follow-up and 58.3% (28/48) who came for one-year follow-up were found to be clear. Conclusion: Donor corneas retrieved from organophosphorus poisoning are safe for transplantation. The postoperative outcome of the tissue utilized from these donors is satisfactory.

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Indications and graft survival analysis in optical penetrating keratoplasty in a tertiary care center in North India: a 5-year study

Abstract: One- and 2-year survival of grafts at our center is lower as compared to western studies, probably due to higher percentage of poor prognosis indications for surgery and a relative scarcity of excellent-quality donor corneas.

Cited by 9 publications

References 20 publications

Outcome of Optical Keratoplasty for Corneal Scar due to Infective Keratitis

Outcome of Optical Keratoplasty for Corneal Scar due to Infective Keratitis

Trends in keratoplasty from central and Northern India. Part I: Indications for keratoplasty

Safety and efficacy of corneal tissue harvested from organophosphorous deceased patients

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