Outcomes of penetrating keratoplasty for endothelial failure at Moorfields Eye Hospital, London, United Kingdom: 2011 - 2014

Abstract

Purpose: To establish up-to-date clinical outcomes including graft survival and refractive outcomes for patients who have had penetrating keratoplasty (PK) for endothelial cell failure, including failed keratoplasties.

Methods: In this ongoing retrospective clinical record analysis, all patients who underwent PK for endothelial failure at Moorfields Eye Hospital between 2011 and 2014 were included. Clinical outcomes including uncorrected visual acuities (UCVA), best corrected visual acuities (BCVA), refractive status, rates of graft rejection and graft failure were analysed.

Results: During the study period, 554 penetrating keratoplasties for endothelial failure (including failed grafts) were performed. 53 cases have so far been reviewed, of which 20 were for previously failed grafts. 96% of the grafts survived at 1 year, and 88% at 3 years. 23% and 53% of patients achieved UCVA and BCVA of 6/12 or better, respectively. Median post-operative sphere, cylinder and refractive spherical equivalent were -5.50 diopters (D), 6.00D and -4.50D respectively. 5 patients required further keratoplasty. 7 patients had secondary ocular hypertension requiring topical treatment, and 2 patients subsequently underwent cataract surgeries.

Conclusions: Penetrating keratoplasty continues to offer excellent visual outcomes and good graft survival rates. Despite the emerging experience with lamellar and endothelial keratoplasties, penetrating keratoplasty remains an important component of our surgical armamentarium.