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Indications, surgical procedures and outcomes of keratoplasty at a Tertiary University-based hospital: a review of 10 years’ experience

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Abstract

Objective

To investigate keratoplasty outcomes in a university-based hospital.

Methods

Medical records of all patients undergoing keratoplasty at King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between January 1, 2006, and December 31, 2015, with a minimum follow-up period of three months were reviewed retrospectively. Indications, surgical procedures, complications and outcomes of all surgeries were collected and analyzed.

Main outcome measures

Graft survival and visual acuity.

Results

Data were available for 488 grafts in the study period, including 313 optical penetrating keratoplasty (PKP), 42 therapeutic/tectonic PKPs, 72 deep anterior lamellar keratoplasty, 58 Descemet’s stripping automated endothelial keratoplasty and 3 Descemet’s membrane endothelial keratoplasty. A total of 389 (79.7%) grafts survived, whereas 99 (20.3%) grafts failed. The projected 1-year, 3-year and 5-year cumulative survival rates for the entire study group were 85.8%, 74.9% and 71.1%, respectively. Corneal ectasia was the commonest surgical indication accounting for 48% of the cases. The best long-term survival rates were observed in the stromal dystrophy and corneal ectasia groups. The worst survival rates were noticed in the congenital corneal opacities group. Vision improved in in 57.5% of grafted eyes, remained the same in 39.8% and deteriorated in 2.7%. Postoperative complications occurred in 36% of the grafts with rejection being the most common, and its mere occurrence increased the risk of graft failure by 20-fold.

Conclusion

The outcome of grafting in a university-based hospital can be excellent in low-risk grafts and fair to low in high-risk grafts. Our results are relatively comparable to nationally and internationally reported outcomes.

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Acknowledgement

The authors would like to greatly thank Mrs. Priscilla W. Gikandi (MPH), Research Unit, Department of Ophthalmology, College of Medicine, King Saud University, for her extensive help with the data management and analysis. The authors would also like to greatly thank Dr. Nawaf Alkharashi for his help in data collection. This research was funded by the Deanship of Scientific Research at Princess Nourah bint Abdulrahman University through the Fast-track Research Funding Program.

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Authors and Affiliations

  1. Department of Ophthalmology, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

    Eman M. Al-Sharif

  2. Department of Ophthalmology, Collage of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia

    Eman M. Al-Sharif & Majed Alkharashi

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  1. Eman M. Al-Sharif
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  2. Majed Alkharashi
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Correspondence to Eman M. Al-Sharif.

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All authors of this study have no conflict of interest to disclose.

Ethical approval

The local Ethics/Research Committee of the Ophthalmology Department of King AbdulAziz University Hospital approved this work which adheres to the tenets of the Declaration of Helsinki.

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A general written informed consent is obtained from each patient or patient’s guardian which includes permission for anonymous data use.

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Al-Sharif, E.M., Alkharashi, M. Indications, surgical procedures and outcomes of keratoplasty at a Tertiary University-based hospital: a review of 10 years’ experience. Int Ophthalmol 41, 957–972 (2021). https://doi.org/10.1007/s10792-021-01731-2

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  • DOI: https://doi.org/10.1007/s10792-021-01731-2

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