Indications for and Outcomes of Repeat Penetrating Keratoplasty

Rapuano, Christopher J.; Cohen, Elisabeth J.; Brady, Steven E.; Arentsen, Juan J.; Laibson, Peter R.

doi:10.1016/s0002-9394(14)72437-7

Cited by 70 publications

(49 citation statements)

References 16 publications

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“…Although the survival rate was relatively low, the data analyses could not be compared with previous studies that addressed single keratoplasty. [17][18][19][20][21] Graft clarity and visual outcome in our study were similar to that of the entire repeated corneal transplanted group and higher than the rate of regraft clarity in eyes complicated by immune graft rejection or glaucoma. 5,9 In conclusion, cataract development after repeated corneal transplantation is a frequent short-and long-term complication.…”

Section: Eyesupporting

confidence: 64%

Development and progression of cataract in patients required repeated corneal transplantation

Rumelt

Blum-Hareuveni

Bersudsky

et al. 2003

Eye

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Purpose To evaluate the incidence of cataract development in patients required repeated corneal transplantations, the types of cataract and the effect of cataract extraction on the corneal regrafts survival. Patients and MethodsThe charts of all the patients that underwent repeated corneal transplantation between 1985 and 1998 were reviewed for the development of cataract after the first or subsequent keratoplasties. In all, 80 patients underwent 122 repeated corneal transplantations, of which six underwent surgery in both eyes. The average follow-up period of all the patients with repeated keratoplasty was 89.5 months from the first keratoplasty.

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Section: Eyesupporting

confidence: 64%

Development and progression of cataract in patients required repeated corneal transplantation

Rumelt

Blum-Hareuveni

Bersudsky

et al. 2003

Eye

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“…Since the traditional treatment for failed grafts has been a repeat PKP, there have been various studies analyzing the outcomes of repeat PKP for graft failure [1][2][3][4][5][6][7][8][9][10] and comparing repeat PKPs to first time PKP [11,12]. Repeat PKPs have been reported to have a poorer prognosis both in terms of visual acuity outcomes and graft survival compared to first time PKPs [1-4, 11, 12].…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes of penetrating keratoplasty versus Descemet’s stripping automated endothelial keratoplasty for penetrating keratoplasty graft failure due to corneal edema

et al. 2012

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To evaluate the outcomes of repeat corneal transplantation, either penetrating keratoplasty (PKP) or Descemet's stripping automated endothelial keratoplasty (DSAEK), for penetrating keratoplasty grafts which failed due to corneal edema. The charts of 24 eyes with failed PKP grafts, due to corneal edema, which underwent a repeat corneal transplant (PKP in 17 eyes [Group 1] and DSAEK in seven eyes [Group 2]) between 2003 and 2007 were retrospectively reviewed. There was no statistically significant difference in the median postoperative visual acuity between the two groups at 1, 2, or 3 years. In Group 1, two (18%) eyes had a final visual acuity ≥ 20/40, in contrast to four (80%) eyes in Group 2, which was statistically significant (P = 0.038). Seven (41%) of the Group 1 eyes developed postoperative complications compared to only one (14%) eye in Group 2. Eleven (65%) of the Group 1 eyes and five (71%) of Group 2 eyes had clear grafts on the last examination. There was no statistically significant difference in the graft survival rate for Group 1 versus Group 2 at 3 years (57.9% vs 68.6%, P = 0.507). There was a trend towards better postoperative visual acuity, a lower postoperative complication rate, and a higher graft survival rate in eyes that underwent DSAEK rather than repeat PKP for graft failure secondary to corneal edema. Given this small, retrospective study, future studies comparing repeat PKP with DSAEK are warranted to determine which procedure allows for improved outcomes.

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“…Hence we have considered complicated aphakic and psuedophakic bullous keratopathy as high risk cases. While the success rate of keratoplasty in favourable eyes is claimed to be 90 to 95% [3], it is significantly less in high-risk cases amounting up to -60-70% [5,8]. In this study also the success rate has been about 73%.…”

Section: Discussionmentioning

confidence: 44%

“…This is expected because in bullous keratopathy, the corneal pathology is due to its poor endothelial status of the cornea and its replacement with a healthy and viable graft with good endothelial cell count prevents recurrence of corneal oedema in the graft. [ [2,5,8,9]. The corrected visual acuity remained stable at twelve weeks and one year follow up visits.…”

Section: Discussionmentioning

confidence: 75%

“…However protected zone is adversely affected by corneal vascularisation, trauma, reduced tear production and previous graft failure [2J. Such eyes along with low-grade uveal inflamation and glaucoma constitute a high risk for keratoplasty [2,3,8]. Though psuedophakic and aphakic bullous keratopathy are by and large considered as good prognostic cases, however in present series such cases were associated with significant preexisting derangement like extensive anterior and posterior synaechiae, poliferation of connective tissue in the angle of anterior chamber, malpositioned IOL and epithelial in growth.…”

Section: Discussionmentioning

confidence: 99%

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Penetrating Keratoplasty in High Risk Cases

Parihar

Rodrigues

Ramchandran

et al. 2001

Medical Journal Armed Forces India

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Penetrating Keratoplasty in high risk cases like paediatric patients, complicated cases of pseudophakic bullous keratopathy, or in patients with highly vascularized corneal opacities have been a challenge for opthalmologists because of the poor outcome. 101 patients with such high risk indications underwent penetrating keratoplasty. Some of them also underwent concurrent procedures like PC IOL implantation or vitrectomy. The patients' follow up period ranged from six months to four years. The results were evaluated. Good quality donor material, good intraoperative tissue handling, aggressive and meticulous postoperative management contributed to gratifying results. However chemical injuries and patients with dry eyes continued to have a bad prognosis and keratoplasty in these cases proved to be unrewarding. MJAFI 2001; 57 : 16-18

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Indications for and Outcomes of Repeat Penetrating Keratoplasty

Cited by 70 publications

References 16 publications

Development and progression of cataract in patients required repeated corneal transplantation

Development and progression of cataract in patients required repeated corneal transplantation

Comparison of outcomes of penetrating keratoplasty versus Descemet’s stripping automated endothelial keratoplasty for penetrating keratoplasty graft failure due to corneal edema

Penetrating Keratoplasty in High Risk Cases

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