Outcome of optical penetrating keratoplasties at a tertiary care eye institute in Western India

Abstract

Aim:To study the indications, risk factors, postoperative course, and long-term survival of corneal transplants done for optical purposes.Design:Retrospective case series.Materials and Methods:Data were obtained by reviewing the records of 181 patients operated at our institute (H.V. Desai Eye Hospital) between October 2005 and October 2007 for optical penetrating keratoplasty. Patients with less than one year of follow up, pediatric cases, therapeutic, tectonic, and lamellar keratoplasties were excluded. Kaplan Meier survival analysis was used to calculate median survival time of grafts and to see correlation between nine variables viz. age, gender, corneal vascularization, previous failed grafts, previous Herpes Simplex keratitis, post-perforation corneal scars, donor tissue quality, graft size, type of surgery and follow-up. These variables were also used for univariate and multivariate analysis using Cox Proportional Hazard Regression Modeling.Results:Median survival of the cohort was 27 months (95% confidence interval: 20.47-33.52). One- and two-year survival rates were 65% and 52.5%, respectively. Median survival was significantly lower in poor prognosis cases (14 months) than good prognosis cases (27 months, P = 0.0405). Graft survival was lower in vascularized corneas (18.55 months, P = 0.030) and in post-perforation corneal scars (17.96 months, P = 0.09, borderline significance). Multivariate analysis showed that the same factors were predictive of graft failure.Conclusion:Long-term survival of grafts at our center is different from centers in western world. More high-risk cases, paucity of excellent quality donor corneas, and differences in patient profile could be the contributory factors.

Effect of transfer of donor corneal tissue from McCarey–Kaufmann medium to Optisol-GS on corneal endothelium

“…Morphologic assessment of the corneal tissues by slit-lamp examination included in the study was excellent on the 1 st day and on the 7 th day were either good or excellent. [ 17 ]…”

“…The donor corneas were graded as excellent, good, or fair based on the slit-lamp examination and specular microscopy. [ 17 ] MK medium stored corneal tissues were transferred to Optisol-GS medium within 48–53 h of retrieval. The upper time limit was decided to eliminate storage media induced endothelial cell loss in MK media.…”

Efeito terapêutico do crosslinking corneal na ceratite infecciosa

“…Thus, even with timely treatment, the inflammatory process may progress with worsening ulceration, corneal melting, and ocular perforation (4,8) . When medical treatment fails, surgical procedures such as a conjunctival flap or corneal transplantation can be used (14)(15)(16) . Studies show that therapeutic transplants represent 2.6% to 17.9% of total penetrating transplants (17) .…”

Corneal transplantation at Tenwek Hospital, Kenya, East Africa: Analysis of outcomes and associated patient socioeconomic characteristics

“…Some details relevant to graft survival were either not recorded or not able to be determined. The degree of corneal vascularization preoperatively, which is known to affect the prognosis of the graft, was not recorded as it is in other studies [ 10 , 22 , 23 ]. Also, although it is well accepted that corneal scars due to herpetic causes fare worse prognostically compared to those due to other causes, given that patients in this study had limited if any eye care prior to initial presentation and often presented with advanced forms of disease, this differentiation could not be determined.…”