Outcomes of Penetrating Keratoplasty in Keratoconus

Javadi, Mohammad Ali; Motlagh, Behzad Fallahi; Jafarinasab, M R; Rabbanikhah, Zahra; Anissian, Arash; Souri, Hamid; Yazdani, Shahin

doi:10.1097/01.ico.0000159730.45177.cd

Cited by 124 publications

(104 citation statements)

References 26 publications

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“…(14)(15)(16)(17)21,22) In a previous series of 90 consecutive PKPs performed in eyes with keratoconus and vernal keratoconjunctivitis between 1986 and 1996 in Saudi Arabia, 83 grafts (92.2%) were clear after a mean follow-up period of 44.7 months.…”

Section: Discussionmentioning

confidence: 99%

“…In a study by Javadi et al, (16) the mean age at the time of surgery was 28.2 years, with 73.2% of patients being male. However, de Lavalette et al (17) reported a female predominance of 65% in their study.…”

Section: Discussionmentioning

confidence: 99%

“…However, de Lavalette et al (17) reported a female predominance of 65% in their study. Various studies have reported that keratoconus has an equal prevalence in both genders, (1,18) a greater prevalence in males, (14)(15)(16)19) and a greater prevalence in females. (20) One possible reason for the increased relative frequency of male subjects undergoing transplantation compared with female subjects is an increased tendency for males to receive surgical treatment so as to improve occupational performance.…”

Section: Discussionmentioning

confidence: 99%

“…( [14][15][16] In this study, PKP was performed in relatively young patients (mean age was 23.72 years at the time of PKP), with a male predominance of 64.0%. In a study by Javadi et al, (16) the mean age at the time of surgery was 28.2 years, with 73.2% of patients being male.…”

Section: Discussionmentioning

confidence: 99%

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Penetrating Keratoplasty for Keratoconus : Visual and Graft Survival Outcomes

Al-Mohaimeed¹

2013

IJHS

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Objectives: To evaluate the complications, and visual and graft survival outcomes in eyes that had undergone penetrating keratoplasty (PKP) for keratoconus. Methodology: 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). Results:The mean age of patients with keratoconus at transplantation was 23.72 years. A preoperative best spectaclecorrected 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. Conclusion: Performing PKP in eyes with keratoconus is associated with good visual results and an excellent graft outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Penetrating Keratoplasty for Keratoconus : Visual and Graft Survival Outcomes

Al-Mohaimeed¹

2013

IJHS

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“…It is a well-established procedure that provides satisfactory visual outcomes as evidenced by several studies (2,3) . However, in recent years, deep anterior lamellar keratoplasty (DALK) has been used as a safer alternative to PK.…”

Section: Introductionmentioning

confidence: 99%

Visual outcomes after deep anterior lamellar keratoplasty using donor corneas without removal of Descemet membrane and endothelium

Prazeres¹,

Müller²,

Rayes³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Approved by the following research ethics committee: Hospital Oftalmológico de Sorocaba (# 1.326.225). RESUMO ABSTRACTPurpose: The optical quality of the interface after deep anterior lamellar keratoplasty (DALK) using the big-bubble technique has been shown to be excellent, leading to results comparable to penetrating keratoplasty. However, there is little in the literature with respect to the controversy surrounding the preparation of the donor cornea. The purpose of this study was to evaluate visual acuity (VA) in patients with keratoconus who underwent DALK without removal of the donor graft endothelium. Methods: The records of 90 patients who underwent DALK without the removal of the Descemet membrane (DM) and endothelium were retrospectively reviewed. Data collected included uncorrected VA (UCVA) and spectacle-corrected VA (SCVA) at 7, 30, 180 days, and 1 year postoperatively. Contact lens-corrected visual acuity (CLVA) was evaluated after 1 year of the procedure. Results: UCVA was significantly better than preoperative values at 7 days (p<0.001), 30 days (p<0.001), 180 days (p<0.001), and 1 year (p<0.001) after surgery. The 1-year postoperative mean SCVA and CLVA also improved when compared with preoperative SCVA (p<0.001 for both). Conclusions: DALK utilizing donor corneas with attached Descemet membrane and endothelium results in satisfactory VA in patients with keratoconus.

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Corneal Transplantation for Keratoconus

Kelly¹

2011

Arch Ophthalmol

102

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To determine factors influencing longterm graft survival and visual acuity in 4834 eyes of 4060 patients receiving their first penetrating corneal graft for keratoconus. Methods: A large cohort study was performed from a national register of corneal grafts in which data were recorded prospectively and analyzed retrospectively. Main outcome measures were graft survival and Snellen visual acuity. Follow-up extended up to 23 years. Results: Kaplan-Meier survival rates of first grafts for keratoconus were 89%, 49%, and 17% at 10, 20, and 23 years, respectively. After 15 years, the graft survival rate was no better than that of all other penetrating grafts (P=.36). Multivariate risk factors influencing failure of first grafts for keratoconus included time to suture removal, postgraft uveitis or microbial keratitis, corneal vascularization prior to or after graft, geographic location of surgery and follow-up (center effect), recipient age at graft, occurrence of rejection episodes, graft size, and surgeon workload. The timing of bilateral grafts made no difference to the risk of rejection. A Snellen visual acuity of 20/40 or better at the most recent follow-up was recorded in 74% of grafts. Conclusions: Penetrating grafts performed for keratoconus exhibited better visual outcome and graft survival than grafts performed for other indications. However, the Kaplan-Meier survival rate of first penetrating grafts for keratoconus was 17% at 23 years after graft and had not plateaued at this time, indicating that young patients are likely to need 1 or more repeated grafts during their lifetime.

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Outcomes of Penetrating Keratoplasty in Keratoconus

Cited by 124 publications

References 26 publications

Penetrating Keratoplasty for Keratoconus : Visual and Graft Survival Outcomes

Penetrating Keratoplasty for Keratoconus : Visual and Graft Survival Outcomes

Visual outcomes after deep anterior lamellar keratoplasty using donor corneas without removal of Descemet membrane and endothelium

Corneal Transplantation for Keratoconus

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