Extended Long-Term Results of Penetrating Keratoplasty for Keratoconus

Purpose: To investigate the extended long-term results of penetrating keratoplasty (PK) for keratoconus. Methods: The subjects were all patients with clinical keratoconus who underwent initial PK at University of Tokyo from 1971 to 1990 and whose medical records were available. Data were retrieved from the medical records. Kaplan-Meier survival analysis was performed to estimate the cumulative probability of immune reaction-free grafts and graft survival. Results: One hundred twenty-five eyes in 125 patients met the entry criteria. The average age at the time of PK was 25.0 ± 8.9 years. With an average follow-up period of 15.3 ± 9.7 years, 12 eyes (9.6%) experienced rejection and 5 eyes (4.0%) experienced graft failure. Average best-corrected visual acuity in logarithm of the minimum angle of resolution at preoperation, 10, 20, and 25 years after surgery was 1.54 ± 0.68, 0.06 ± 0.22, 0.03 ± 0.17, and 0.14 ± 0.42, respectively. The cumulative probability of graft survival at 10, 20, and 25 years after PK was 98.8%, 97.0%, and 93.2%, respectively. Conclusions: Recovery of visual acuity was good after PK for keratoconus in an extended follow-up. The graft survival rate, however, gradually decreased 20 years after PK.

[1]  D. Musch,et al.  Extended long-term outcomes of penetrating keratoplasty for keratoconus. , 2006, Ophthalmology.

[2]  Sanjay V. Patel,et al.  Corneal endothelium and postoperative outcomes 15 years after penetrating keratoplasty. , 2005, Transactions of the American Ophthalmological Society.

[3]  Andrew D Dick,et al.  Predicting endothelial cell loss and long-term corneal graft survival. , 2003, Investigative ophthalmology & visual science.

[4]  Robert W. Thompson,et al.  Long-term graft survival after penetrating keratoplasty. , 2003, Ophthalmology.

[5]  T. Oshika,et al.  Risk factors for corneal graft failure and rejection in penetrating keratoplasty. , 2001, Acta ophthalmologica Scandinavica.

[6]  J. Naor,et al.  Corneal Graft Outcome Study , 2001, Cornea.

[7]  R. Olson,et al.  Penetrating keratoplasty for keratoconus: a long-term review of results and complications. , 2000, Journal of cataract and refractive surgery.

[8]  D. Hodge,et al.  Ten-year postoperative results of penetrating keratoplasty. , 1998, Ophthalmology.

[9]  L. Dandona,et al.  Survival analysis and visual outcome in a large series of corneal transplants in India , 1997, The British journal of ophthalmology.

[10]  T. Tsuru,et al.  Risk factors for graft failure in penetrating keratoplasty. , 2009, Acta ophthalmologica Scandinavica.

[11]  T A Casey,et al.  Penetrating keratoplasty for keratoconus: complications and long-term success. , 1991, The British journal of ophthalmology.

[12]  T. Olsen,et al.  LONG TERM RESULTS OF CORNEAL GRAFTING IN KERATOCONUS , 1983, Acta ophthalmologica.

[13]  P. Paglen,et al.  The prognosis for keratoplasty in keratoconus. , 1982, Ophthalmology.