Abstract
Abstract: :
Purpose:To review the outcome and donor tissue characteristics for penetrating keratoplasty (PK). Methods:: Retrospective review of files at the cornea department from 1999 to 2001 that underwent penetrating keratoplasty. We studied the postoperative outcome according to the risk of rejection due to the preoperative diagnosis. We divided the patients in: Group I: Low risk (corneal ectasia), Group II: Medium risk (dystrophies and bullous keratopathy) and Group III: High risk (Interstitial Keratitis, trauma, regrafts, etc.). Results:: A total of 144 files were reviewed. Eighty five patients were male and 59 were female. The average recipient age was 39.34 years ( range 2 to 86). The preoperative diagnosis was: Keratoconus (33.6%), Bullous keratopathy (17.74%), Interstitial Keratitis (11.82%), Trauma (11.29%), and Fuchs´Distrophy (4.83%). A simple procedure was made in 103 patients and combines in 31 patients. The follow up period was 21.2 months (12 to 31 months). The success rate at the first year was 79.16%. In group I was 94%, group II 84.84% and group III 63.39% (p=0.009). In combine surgeries the success rate was in group II 75% and in group III 31.03% (p=0.04). The average donor age was 54.27 years for group I, 55.59 years for group II and 56.04 years for group III. The preoperative average endothelial cell count was in group I: 2462.53 cells, group II 2770.88 cells and group III 2619.56 cells. The main causes of failure were allograft rejection in 76.66%, primary failure 10%, secondary failure other than rejection in 13.33%. Rejection was observed in 8 patients (16%) in group I, 12 patients (36.2%) in group II and 50 patients (49.1%) in group III. Conclusion:: The leading indications for PK in our hospital are different from those of developed countries. The rate of success is 79.16% as in the written literature. The main factors that worsen the final outcome are high risk indication, rejection and combined surgery.
Keywords: 353 clinical (human) or epidemiologic studies: outcomes/complications • 371 cornea: endothelium • 607 transplantation