Trends in the Indications for Penetrating Keratoplasty, 1980-2001

Kang, Paul C.; Klintworth, Gordon K.; Kim, Terry; Carlson, Alan N.; Adelman, Ron A.; Stinnett, Sandra S.; Afshari, Natalie A.

doi:10.1097/01.ico.0000157407.43699.22

Cited by 97 publications

(56 citation statements)

References 15 publications

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“…In a study by Nagra et al (12) , the most common indication for PK among patients who developed WD was also keratoconus, followed by Fuch's endothelial dystrophy and pseudophakic bullous keratopathy. This is in contrast to the most common indication for corneal transplantation performed in the United States and United Kingdom, which is graft failure (13,14) . Other indications include pseudophakic or aphakic bullous keratopathy, Fuch's endothelial dystrophy, keratoconus, and viral keratitis (13,14) .…”

Section: Discussionmentioning

confidence: 95%

Traumatic wound dehiscence after corneal keratoplasty

Tzelikis¹,

Fenelon²,

Yoshimoto³

et al. 2015

Arquivos Brasileiros De Oftalmologia

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Purpose: To assess patient characteristics, risk factors, outcomes, and the treatment of wound dehiscence (WD) in patients after corneal keratoplasty. Methods: Retrospective chart review of 11 eyes of 11 patients with corneal grafts who underwent repair of WD from January 1, 2004 to December 31, 2012 at Hospital Oftalmologico de Brasilia. Results: Eight (72.7%) patients were men and three were women. Six (54.5%) patients had deep anterior lamellar keratoplasty (DALK) and 5 had penetrating keratoplasty. The mean age at trauma was 31.1 years. The mean time from corneal keratoplasty to WD was 12.82 months (range, 3-33 months). The mean best-corrected visual acuity of patients before trauma was 20/60 (0.48 logMAR) and after final treatment was 20/160 (0.90 logMAR) (P=0.15). In one case, visual acuity decreased to no light perception because of retinal detachment and phthisis bulbi. Accidental blunt trauma and fall were the most common causes of WD. Conclusion: Patients who undergo corneal keratoplasty have a life-long risk of WD. The full-thickness rupture at the graft-host junction in our study suggests that the junction remains vulnerable, even following DALK, and can rupture with trauma. In our series, depending upon the severity of the trauma, postkeratoplastic WD can be associated with a good visual prognosis.

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Section: Discussionmentioning

confidence: 95%

Traumatic wound dehiscence after corneal keratoplasty

Tzelikis¹,

Fenelon²,

Yoshimoto³

et al. 2015

Arquivos Brasileiros De Oftalmologia

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“…40,60 In recent years, selective replacement of the diseased endothelium with a donor endothelial graft has superseded traditional full-thickness penetrating keratoplasty (PKP), 92 with endothelial keratoplasty (EK) constituting 40% of all corneal grafts in the USA in 2010 -compared with only 4.5% in 2005. 5 Full thickness PKP may still be required when anterior stromal scarring has occurred secondary to the underlying endothelial pathology, although significant visual improvements have still been achieved with EK in such cases.…”

Section: Introductionmentioning

confidence: 99%

Determinants of visual quality after endothelial keratoplasty

Turnbull

Tsatsos

Hossain

et al. 2016

Survey of Ophthalmology

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Endothelial keratoplasty is now favored over full-thickness penetrating keratoplasty for corneal decompensation secondary to endothelial dysfunction. Although endothelial keratoplasty has evolved as surgeons strive to improve outcomes, fewer patients than expected achieve best corrected visual acuity of 20/20 despite healthy grafts and no ocular comorbidities. Reasons for this remain unclear, with theories including anterior stromal changes, differences in graft thickness and regularity, induced high order aberrations, and the nature of the graft-host interface. Newer iterations of endothelial keratoplasty such as thin manual DSEK, ultrathin DSAEK, and DMEK have achieved rates of 20/20 acuity of approximately 50%, comparable to modern cataract surgery , and it may be that a ceiling exists, particularly in the older age group of patients. Establishing the relative contribution of the factors that determine visual quality following endothelial keratoplasty will help drive further innovation, optimising visual and patient-reported outcomes while improving surgical efficacy and safety.

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“…Ectatic diseases, such as keratoconus, pellucid marginal degeneration, and keratoglobus, are characterized by progressive thinning and distortion of the cornea, and as a class, represent a leading indication for corneal transplantation. 1,2 It is imperative to avoid the potential destabilizing effects of photoablative corneal refractive surgery in corneas that are predisposed to biomechanical instability, because postoperative ectasia is a major clinical concern.…”

Section: Introductionmentioning

confidence: 99%

Method for optical coherence elastography of the cornea

et al. 2011

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Abstract. The material properties of the cornea are important determinants of corneal shape and refractive power. Corneal ectatic diseases, such as keratoconus, are characterized by material property abnormalities, are associated with progressive thinning and distortion of the cornea, and represent a leading indication for corneal transplantation. We describe a corneal elastography technique based on optical coherence tomography (OCT) imaging, in which displacement of intracorneal optical features is tracked with a 2-D cross-correlation algorithm as a step toward nondestructive estimation of local and directional corneal material properties. Phantom experiments are performed to measure the effects of image noise and out-of-plane displacement on effectiveness of displacement tracking and demonstrated accuracy within the tolerance of a micromechanical translation stage. Tissue experiments demonstrate the ability to produce 2-D maps of heterogeneous intracorneal displacement with OCT. The ability of a nondestructive optical method to assess tissue under in situ mechanical conditions with physiologic-range stress levels provides a framework for in vivo quantification of 3-D corneal elastic and viscoelastic resistance, including analogs of shear deformation and Poisson's ratio that may be relevant in the early diagnosis of corneal ectatic disease. C 2011 Society of Photo-Optical Instrumentation Engineers (SPIE).

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Trends in the Indications for Penetrating Keratoplasty, 1980-2001

Abstract: In this study, failed graft has gradually become the leading indication for PK, whereas most other studies have reported PBK as the leading indication. Unlike many other studies, Fuchs dystrophy was a common indication for PK.

Cited by 97 publications

References 15 publications

Traumatic wound dehiscence after corneal keratoplasty

Traumatic wound dehiscence after corneal keratoplasty

Determinants of visual quality after endothelial keratoplasty

Method for optical coherence elastography of the cornea

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