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V.M. Borderie, O. Touzeau, T. Bourcier, C. Allouch, F. Thomas, L. Laroche; Factors Influencing the Outcome of Penetrating Keratoplasty . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2709.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To identify predictive factors for the outcome of penetrating keratoplasty. Methods: Prospective cohort study. 856 consecutive penetrating keratoplasties (772 patients) performed between 1992 and 2001 were analyzed and 772 were included. Patients were followed for an average of 55 months. Graft clarity and endothelial cell density (ECD) were recorded. Results: The overall graft survival was 72% at 60 months. It was significantly influenced by donor tissue storage time (p = 0.03), recipient age (p = 0.0001), recipient rejection risk (p < 0.0001), preoperative corneal disease (p < 0.0001), and lens status (p < 0.0001). The average ECD was 2,236 cells/mm2 preoperatively (n = 772), 1,582 cells/mm2 during the 2nd year (n = 430), 1,232 cells/mm2 during the 4th year (n = 277), 982 cells/mm2 during the 6th year (n = 131), and 937 cells/mm2 during the 10th year (n = 19). Preoperative ECD significantly correlated with postoperative ECD at 2 years (r = +0.33), 4 years (r = 0.33) and 6 years (r = 0.19). Postoperative ECD at 2 years (r = –0.20) and 4 years (r = –0.13) decreased with donor tissue storage time. It also decreased with the preoperative coefficient of variation of the graft endothelium (r = –0.43), but only at 6 years postoperatively. In successful grafts, the postoperative endothelial cell loss increased with postoperative time (y = –0.17Ln(x) + 0.17). Based on this model, the graft average cell loss would be 80% at 25 years postoperatively. Conclusions: The lifespan of a graft after PK seems to be limited to 3 decades.
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