Penetrating Keratoplasty in Nepal

Tabin, Geoffrey; Gurung, Rita; Paudyal, Govinda; Reddy, Harsha; Hobbs, Cara L; Wiedman, Michael; Ruit, Sanduk

doi:10.1097/01.ico.0000121712.36593.0d

Cited by 42 publications

(27 citation statements)

References 23 publications

(21 reference statements)

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“…It analyzed changes in UCVA, BCVA, This technique also postpones the immediate necessity for corneal graft PKP. 30 Tabin et al 44 report a post-PKP UCVA of 20/200 or better in 61.5% of cases and 20/60 or better in 15% of cases.…”

Section: Discussionmentioning

confidence: 96%

Penetrating keratoplasty versus intrastromal corneal ring segments to correct bilateral corneal ectasia: Preliminary study

Rodríguez¹,

Guillén²,

Benavides³

et al. 2007

Journal of Cataract and Refractive Surgery

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Section: Discussionmentioning

confidence: 96%

Penetrating keratoplasty versus intrastromal corneal ring segments to correct bilateral corneal ectasia: Preliminary study

Rodríguez¹,

Guillén²,

Benavides³

et al. 2007

Journal of Cataract and Refractive Surgery

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“…According to a study done in Nepal, corneal scars following infectious keratitis, adherent leucomas, and corneal perforations were the major indications for surgery. [10] A study done in India to analyze survival rate of corneal transplants in a large series shows survival rates at 1, 2, and 5 years for first-time grafts to be 79.6%, 68.7%, and 46.5%, respectively. [11] They are different from the western studies essentially due to differences in patient profile, different indications for surgery, differences in methods of storage of corneas, and socioeconomic factors affecting healthcare provision.…”

Section: Discussionmentioning

confidence: 99%

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

Joshi

Jagdale

et al. 2012

Indian J Ophthalmol

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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.

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“…Indication for surgery has been shown to be an important determinant of graft survival both in the US 5 and internationally. 2,6–8 Since patients undergoing penetrating keratoplasty for keratoconus (KCN) have an excellent prognosis it has been suggested that graft survival in KCN can be used as a comparison between different centers and countries. 9 Graft survival of KCN in our series was excellent and quite comparable to other series.…”

Section: Discussionmentioning

confidence: 99%

Penetrating Keratoplasty at a Tertiary Referral Center in Ethiopia: Indications and Outcomes

Ayalew¹,

Tilahun

Holsclaw

et al. 2017

Cornea

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Purpose To describe the indications, visual acuity outcomes and graft survival after penetrating keratoplasty in Addis Ababa, Ethiopia. Methods The medical records of patients who had penetrating keratoplasty (PKP) at Menelik II Hospital between September 2000 and September 2013 were retrospectively reviewed. The pre-specified outcomes were graft survival, visual acuity, and complication rates. Results A total of 321 patients underwent penetrating keratoplasty during the study period and were included in the analysis. The indications for surgery were trachoma or leukoma in 141 (44%), keratoconus (KCN) in 45 (14%), corneal dystrophy in 46 (14%), pseudophakic or aphakic bullous keratopathy in 28 (9%), trauma in 27 (8%), prior graft failure in 18 (6%), active ulcer, burn or perforation 9 (3%), and other 7 (2%). Graft survival was 80% overall at 2 years but varied considerably depending on indication for surgery. Uncorrected visual acuity improved from baseline mean logMAR 2.09 (SD 0.67) to mean logMAR of 1.53 (SD 1.03) at 2 years. A number of factors affected visual acuity outcomes. Patients were not routinely refracted, and only 18% (N = 60) of patients had access to corrective spectacles or contact lenses post-operatively. Complication rates were high with infectious keratitis being the most common. Conclusions Penetrating keratoplasty is becoming a viable treatment for corneal opacity in developing countries. However, the high burden of disease and lack of corrective lenses remain significant obstacles to overcome.

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Penetrating Keratoplasty in Nepal

Abstract: The corneal diseases and indications for transplant surgery in Nepal are different from those in the Western world. Despite these differences, penetrating keratoplasty is a successful and reasonable way to reduce corneal blindness in developing nations.

Cited by 42 publications

References 23 publications

Penetrating keratoplasty versus intrastromal corneal ring segments to correct bilateral corneal ectasia: Preliminary study

Penetrating keratoplasty versus intrastromal corneal ring segments to correct bilateral corneal ectasia: Preliminary study

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

Penetrating Keratoplasty at a Tertiary Referral Center in Ethiopia: Indications and Outcomes

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