Abstract
Purpose: :
To assess the visual outcome after unilateral penetrating keratoplasty (PKP) in a heterogenous group of corneal disorders in cases with normal fellow eye.
Methods: :
A retrospective analysis of hospital records of all patients that underwent penetrating keratoplasty at the Corneal Unit of the Royal Victorian Eye and Ear Hospital, Melbourne, between January 1997 and June 2006, was performed. All cases with a history of one or more corneal transplantation surgery in one eye and a best corrected visual acuity (BCVA) ≥0.5 in the fellow eye with no corneal pathology were included. The main outcome measures were indications for corneal graft, best-corrected visual acuity at 2 years and overall graft survival.
Results: :
Of the 498 grafts performed during the study period, 30 eyes (6%) met the inclusion criteria. Mean age of the patients was 56 ± 22 years (range: 16-86 years). Most common indication for penetrating keratoplasty in the study group was bullous keratopathy (40%), followed by keratoconus (34%), corneal scar (13%) and failed graft (13%). Mean post operative BCVA at 2 years (0.32 ± 0.28; range 0.001-1.2) was less as compared to the mean BCVA of fellow eye (0.81 ± 0.23; range 0.5-1.2) [p=0.56]. Although 97% grafts remained clear at the end of two years follow-up, only 24% of patients could attain BCVA of ≥0.5. In 72% of eyes BCVA was ≥ 2 lines less than that of the fellow eye.
Conclusions: :
In our study bullous keratopathy was the most common indication for unilateral keratoplasty in cases with normal fellow eyes. The final BCVA obtained in majority of these cases was suboptimal as compared to that of fellow eyes.
Keywords: cornea: clinical science • visual acuity • low vision