Penetrating Keratoplasty for Keratoconus : Visual and Graft Survival Outcomes

Al-Mohaimeed, Mansour

doi:10.12816/0006023

Cited by 18 publications

(7 citation statements)

References 30 publications

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“…The BCVA with hard contact lens of 29 eyes without amblyopia in our study was 20/27. This result is similar to the results of previous studies, with the BCVA ranged from 20/25 to 20/32 [7], [8], [11], [13].…”

Section: Discussionsupporting

confidence: 92%

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Penetrating Keratoplasty for Keratoconus in Vietnamese Patients

Cung¹,

Nga²,

Ngan³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Keratoconus is an ectatic corneal disorder that can impair the visual acuity. Up to now, penetrating keratoplasty (PK) remains the most common surgical procedure to treat severe keratoconus. In Vietnam, most keratoconus patients come to visit doctor at severe stage and were treated by PK, so we conduct this study. AIM: To evaluate the results of PK for keratoconus in Vietnamese patients. METHODS: This was a retrospective study of 31 eyes with keratoconus who underwent PK in VNIO from January 2005 to December 2014. RESULTS: The average visual acuity was 0.86 ± 0.37 logMAR (20/145). In the group of patients without amblyopia, best spectacle-corrected visual acuity of 20/60 or better was recorded in 75.9% of eyes and 93.1% of eyes achieved a best corrected visual acuity with hard contact lenses of 20/40 or better. Mean postoperative corneal power was 43.8 ± 4.5D. Mean corneal astigmatism was 5.9 ± 2.7D. 94.6% of grafts remained clear. Posterior subcapsular cataract developed in 22.6% of eyes. Graft rejection was recognized in 12.9% of eyes. CONCLUSION: PK is an effective procedure with high rate of graft survival for keratoconus patients. However, patients should be aware of the necessary of optical correction to gain the best VA after surgery.

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Section: Discussionsupporting

confidence: 92%

“…The successful rate of PK for keratoconus is higher than other diseases. After 5 to 12 years, the graft survival rate is more than 90% [6], [7], [8].…”

Section: Introductionmentioning

confidence: 99%

Penetrating Keratoplasty for Keratoconus in Vietnamese Patients

Cung¹,

Nga²,

Ngan³

et al. 2019

Open Access Maced J Med Sci

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“…(11) Similarly, Dandona et al reported a 95.1% survival rate at 5 years (12). Immune rejection is the most common cause of graft failure after PKP (10,13). In our study, all 3 graft failures were secondary to graft rejection.Among the donor-related risk factors in our study, donor age was not associated with an increased risk of rejection.…”

supporting

confidence: 71%

Risk Factors for Corneal Graft Rejection after Penetrating Keratoplasty for Keratoconus

Alsubaie,

Alrubaian,

Ahmad

et al. 2023

Preprint

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Purpose To evaluate the association between donor-related factors and the risk of rejection in patients undergoing penetrating keratoplasty (PKP) for keratoconus. Methods A Retrospective review was performed of keratoconus patients with no corneal neovascularization who underwent PKP from November 2014 to December 2016 and completed at least two years of follow-up. Preoperative, donor, operative, and postoperative data were collected and analyzed to identify factors leading to corneal graft rejection. Results Among the 201 patients (201 eyes) who underwent PKP, 46 patients (22.9%) had an episode of graft rejection. The graft survival rate was 98.5%. Grafts with a death-to-excision time (DET) greater than 8 hours had a 0.53X lower risk of rejection compared with grafts with DET within 8 hours or less (P = 0.05). Rejection was higher in patients receiving grafts with a preservation time within 7 days or less compared with preservation time greater than 7 days (30.6% vs. 21.2%, respectively, P = 0.291). The rejection rate was higher in patients with a history of corneal transplant in the fellow eye than those without keratoplasty in either eye (32.7% vs. 19.2%, respectively; P = 0.077). Graft rejection was 2.4 times higher if recipients developed postoperative stromal neovascularization (P = 0.003). Conclusion Short DET could be an independent risk factor for rejection after PKP. There were no strong correlations between graft rejection and donor age, donor/recipient gender, or graft size.

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“… 21 Postoperative visual acuity of 20/20 to 20/40 was noted in 68% of 311 eyes with keratoconus that had undergone primary PKP. 22 This rate further declined when PKP was performed to manage failed graft with functional vision in only 4.8% of eyes. 23 The learning curve among postgraduate students at our teaching institute could be an alternative explanation of lower outcomes with PKP.…”

Section: Discussionmentioning

confidence: 99%

Descemet stripping automated endothelial keratoplasty (DSAEK) versus repeat penetrating keratoplasty (PKP) to manage eyes with failed corneal graft

Khairallah

2018

Annals of Saudi Medicine

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BACKGROUNDFailed corneal graft management is a challenge. Descemet stripping automated endothelial keratoplasty (DSAEK) and repeat penetrating keratoplasty (PKP) are two options. Only two studies have compared outcomes of DSAEK and PKP in the management of a failed graft.OBJECTIVETo compare the visual outcomes, changes in intraocular pressure (IOP) and complications in eyes with failed corneal grafts that were subsequently managed with DSAEK and PKP.DESIGNRetrospective cohort study.SETTINGSTertiary eye hospital of central Saudi Arabia.PATIENTS AND METHODSA retrospective chart review was performed for cases managed between 2007 and 2012. Data were collected on the best-corrected visual acuity (BCVA) before and at day 1, 1 week, 4 weeks, 12 weeks, and 24 weeks after intervention. BCVA was compared in patients managed with DSAEK or PKP. Intra- and postoperative complications were compared in both groups.MAIN OUTCOME MEASURESClear graft, vision at last follow up, complications.RESULTSThere were 15 eyes in the DSAEK group and 30 in the PKP group. The causes of previously failed PKP differed between groups. BCVA at 6 months after repeat surgeries was 20/20 to 20/40 in 4 (27%) eyes in the DSAEK group and in 8 (27%) eyes in the PKP group. The IOP at 6 months was statistically significantly higher in the DSAEK group than the PKP group (P=.006). In DSAEK group, one graft rejection occurred in one eye and graft dislocation in another eye. Seven eyes in PKP group had signs of graft rejection that regressed in 5 eyes following medical management.CONCLUSIONSDSAEK and PKP for previously failed corneal graft resulted in similar BCVA 6 months after repeat surgery. However, the visual outcomes were less promising with both types of surgeries. The lower complication rate and surgical ease may favor DSAEK over PKP in managing failed grafts.LIMITATIONSSmall sample, retrospective study.

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Penetrating Keratoplasty for Keratoconus : Visual and Graft Survival Outcomes

Cited by 18 publications

References 30 publications

Penetrating Keratoplasty for Keratoconus in Vietnamese Patients

Penetrating Keratoplasty for Keratoconus in Vietnamese Patients

Risk Factors for Corneal Graft Rejection after Penetrating Keratoplasty for Keratoconus

Descemet stripping automated endothelial keratoplasty (DSAEK) versus repeat penetrating keratoplasty (PKP) to manage eyes with failed corneal graft

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