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Cristina Fernandez, Oscar Fernandez, Regina Velasco, Oscar Baca, Alejandro Babayan, Elisa Dessire Alegria, Cristina Pacheco Del Valle, ; Evolution of penetrating keratoplasty in a reference hospital in Mexico City a five years study.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5453.
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To know incidence of cases, graft survival, rate of rejection and failure, factors that influence the success in penetrating keratoplasty (PK).
A historic cohort from 2006 to 2011 was evaluated. Medical records of patients undergoing PK considering the following inclusion criteria were reviewed: 1 year minimum follow up, history of PK. Record details of identification, PK indication, previous vascularization were recorded, behavior was evaluated in the reporting evolution notes presence of infection, increased intraocular pressure, epithelial defect, rejection episodes were also noted. As outcome success or failure of the graft at the time of last report in the record.
A total of 147 records of 147 patients who underwent penetrating keratoplasty for the different causes were included in the study. The age range was from 8 to 87 years, median was 39 years. Regarding gender distribution 44% were female and 56% male. The surgery performed was penetrating keratoplasty in 73% of the cases. The most frequent indication was keratoconus with 39.6%, followed by 20.8% bullous keratopathy, interstitial keratitis 10%, Tectonic and flap previous 6% and 4% Fuchs dystrophy. Most successful PK indication was Keratoconus with 58 of 59 cases. The presence of rejection in at least one occasion, persistent epithelial defect and vascularization were found as factors influencing graft survival all with a p <0.005.
The overall transplant survival is excellent in patients who are under careful observation. Patient selection, proper management of donor corneal tissue, preoperative and postoperative evaluation are crucial to the success of corneal transplantation. While overall survival QPP excellent short-term, long-term survival remains a topic of interest. The high number of these procedures underscores the importance of the PK as a method for restoring vision.
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