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Adina Agapie, Jean M. Perone, Pierre J. Bertaux, Monica Lacusteanu, Audrey Baudot, Piotr Lasota, Soydan Kurun, Heni Mnasri; Long-term Follow-up Of Penetrating Keratoplasty: Retrospective Study About 251 Corneal Grafts And 10 Years Of Follow-up. Invest. Ophthalmol. Vis. Sci. 2011;52(14):353.
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The authors report their experience regarding the long-term follow-up of the penetrating keratoplasty (KP), by presenting the following elements: KP’s various indications, visual acuity evolution, anatomical success rate, main complications.
Study included 251 KP, performed by the same surgeon between Sept 2000 and Oct 2010. We analyzed KP’s various indications, patients’ age, interventions’ characteristics, visual and functional results observed before KT and after 1, 12 and 60 months of follow-up, failure and rejection rate, main complications. The patients were divided into 2 groups: 1st group-eyes operated for analgesic aim (107 cases 42.63%) and 2nd group for which a visual improvement was also expected (144 cases 57.37%).
Patients mean age was 68.4 years (17-97). There were 48.61% of women and 51.39% of men. Mean follow-up was of 32.06 months (1 to 108). A combined cataract surgery was associated in 16.33% of cases, and an IOL change in 11.55%. Mean intervention’s duration was of 39.9mn (from 20 to 100mn). The main KP indications were: pseudophakic bullous keratopathy on anterior chamber IOL (18.33%), posterior chamber IOL (18.73%), keratoconus (14.34%), previous graft failure (14.34%), corneal infection (11.16%) and Fuchs dystrophy (7.57%). At the end of follow-up period, there were 63.16% totally transparent grafts in the 1st group and 73.08% in the 2nd group. The visual acuity level, for the 2nd group, varied on Logmar scale from 1.42 before keratoplasty, to 1.06 at 1 month, 0.54 at 12 months and 0.75 at the end of follow-up. From the complications perspective, we noted 12 cases of immune rejection (4.5%), 14 cases of ocular hypertension (5.3%). 91.24% of the 2nd group patients have a continuous growth of the visual acuity over the average follow-up period, with a faster ascent in the first 12 months. A complication occurred during the first year of follow-up does not significantly affects either the graft’s clarity or the visual acuity. However, the statistical analysis shows that a complication occurred between 30 and 60 months of follow-up determines an important visual acuity decline.
Reported data shows that the graft’s clinical evolution varies with the initial etiology, with a better evolution for the young patients and indication of keratoconus. Long term results remain relatively good from the grafts’ transparency and the visual acuity point of view, for the eyes free of associated comorbidity. These data are comparable to those found in the literature.
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