Long-term graft survival after penetrating keratoplasty☆
Section snippets
Material and methods
This is a longitudinal study of a sequential series of 3992 PKPs performed by the surgeons at Corneal Consultants of Indiana over a 14-year period from 1982 through 1996 and does not include penetrating grafts for marginal ulcerations or patch grafts. The center is a private, tertiary care referral center located in Indianapolis, Indiana. Patients referred to this practice are primarily from Indiana and the surrounding Midwestern United States. The data were collected retrospectively from
Results
Table 1 summarizes cohort demographic data as categorized by the primary preoperative diagnosis at the time of keratoplasty. The most frequent indications for corneal transplantation were PBK (32.3%), and Fuchs’ dystrophy (22.7%). The average age at the time of transplant was 67 years (range, 1–98 years). Whites represented 96% of the patients undergoing PKP. Female patients exceeded male patients for all diagnostic categories, except keratoconus and herpes simplex keratitis. The mean follow-up
Discussion
This report of 10-year PKP follow-up expands on previously published results of 5-year corneal graft survival.3 The number of study eyes increased from 1819 to 3992, and this study ranks as one of the largest worldwide to document long-term results of PKP. The study population was largely white, reflecting the racial composition of the state of Indiana.19 Since the previous report, the mean age of the study population increased from 58 years (range, 4–82 years) to 67 years (range, 1–98 years),
Conclusions
In summary, PKP is an effective and safe long-term treatment for anterior segment pathology. The overall long-term survival rate of corneal grafts in this study was excellent, with a 5-year survival rate of 88% and a 10-year survival rate of 80%. The incidence of some etiologies of graft failure varied over time. Surface-related difficulties were most commonly encountered in the first year after surgery, and astigmatism was a potential problem 1 to 2 years after suture removal. Immunologic
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Manuscript no. 220351.
Supported by grants from the Indiana Lion’s Eye Bank, Indianapolis Indiana, and the Cornea Research Foundation of America, Indianapolis, Indiana.