OBJECTIVE
To determine the graft survival, visual outcome, complications, and frequency of subsequent cataract extraction after penetrating keratoplasty for Fuchs' dystrophy.
DESIGN
The medical records of 236 patients with the diagnosis of Fuchs' dystrophy who were examined on the Cornea Service at Wills Eye Hospital, Philadelphia, Pa, between January 1, 1988, were reviewed retrospectively.
SUBJECTS
Penetrating keratoplasties had been or were subsequently performed on 130 phakic eyes of the 236 patients with Fuchs' dystrophy. Results were analyzed in 126 eyes with at least 1 year of follow-up. Statistical analysis was done to determine the risk factors for subsequent cataract surgery in the first eye of patients who had penetrating keratoplasty as their initial surgical procedure.
RESULTS
Mean +/- SD follow-up after transplantation was 8.4 +/- 4.8 years. The graft remained clear in 112 eyes (89%). A best corrected acuity of 20/40 or better was achieved in 81 eyes (64%). Graft rejection occurred in 37 eyes (29%). Subsequent cataract surgery was performed in 55 eyes (44%), and the mean time from transplantation was 3.5 +/- 3.4 years. Advanced age at the time of transplantation was a significant risk factor for having cataract extraction (P = .003, Mantel-Haenszel chi 2 test) and a shorter time to cataract surgery after penetrating keratoplasty (P = .04, Mantel-Haenszel chi 2 test). Pregraft lens status approached significance as a risk factor for subsequent cataract surgery (P = .07, Mantel-Haenszel chi 2 test).
CONCLUSIONS
Long-term results are favorable after penetrating keratoplasty for Fuchs' dystrophy. In older patients with Fuchs' dystrophy and mild-to-moderate lens changes, combines penetrating keratoplasty, cataract extraction, and intraocular lens implantation procedure should be considered.
[1]
C. Legault,et al.
Cataract formation and cataract extraction after penetrating keratoplasty.
,
1994,
Ophthalmology.
[2]
S. Gore,et al.
Corneal graft survival and visual outcome. A multicenter Study. Corneal Transplant Follow-up Study Collaborators.
,
1994,
Ophthalmology.
[3]
B. Munoz,et al.
Prevalence of lens opacities in surgical and general populations.
,
1991,
Archives of ophthalmology.
[4]
T A Casey,et al.
Penetrating keratoplasty for keratoconus: complications and long-term success.
,
1991,
The British journal of ophthalmology.
[5]
W. V. Van Meter,et al.
Postkeratoplasty astigmatism control. Single continuous suture adjustment versus selective interrupted suture removal.
,
1991,
Ophthalmology.
[6]
R. Vanderzwaag,et al.
Cataract Formation Following Corneal Transplantation in Eyes with Fuchs' Endothelial Dystrophy
,
1990,
Cornea.
[7]
E. Cohen,et al.
Clinical indications for and procedures associated with penetrating keratoplasty, 1983-1988.
,
1989,
American journal of ophthalmology.
[8]
D. Musch,et al.
Corneal astigmatism after penetrating keratoplasty. The role of suture technique.
,
1989,
Ophthalmology.
[9]
P. Binder,et al.
The effect of suture removal on postkeratoplasty astigmatism.
,
1988,
American journal of ophthalmology.
[10]
R. Sperduto,et al.
The prevalence of nuclear, cortical, and posterior subcapsular lens opacities in a general population sample.
,
1984,
Ophthalmology.
[11]
T. Olsen,et al.
LONG TERM RESULTS OF CORNEAL GRAFTING IN FUCHS‘ ENDOTHELIAL DYSTROPHY
,
1984,
Acta ophthalmologica.