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Corneal transplantation for keratoconus: a registry study
Thu-Lan Kelly1, Keryn A Williams, Douglas J Coster
1Department of Ophthalmology, Flinders University, Adelaide, Australia.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|February 16, 2011
Summary
First penetrating corneal grafts for keratoconus show promising visual acuity but declining long-term survival rates. Factors like rejection episodes and post-surgery infections significantly impact graft success, suggesting potential need for repeat procedures in young patients.
Area of Science:
- Ophthalmology
- Transplantation Surgery
- Corneal Diseases
Background:
- Keratoconus is a progressive corneal condition often requiring penetrating keratoplasty.
- Long-term outcomes of corneal grafts for keratoconus are crucial for patient quality of life.
Purpose of the Study:
- To identify factors influencing graft survival and visual acuity in first-time penetrating corneal grafts for keratoconus.
- To analyze long-term outcomes up to 23 years post-transplantation.
Main Methods:
- A large cohort study utilizing a national corneal graft registry.
- Prospective data recording and retrospective analysis.
- Kaplan-Meier survival analysis and multivariate risk factor assessment.
Main Results:
- First grafts for keratoconus had survival rates of 89% (10 years), 49% (20 years), and 17% (23 years).
- Key risk factors for graft failure included suture removal time, post-graft inflammation/infection, vascularization, center effect, recipient age, rejection, graft size, and surgeon workload.
- 74% of grafts achieved a visual acuity of 20/40 or better.
Conclusions:
- Penetrating grafts for keratoconus demonstrate superior visual outcomes compared to other indications.
- Graft survival rates for keratoconus have not plateaued by 23 years, indicating a high likelihood of repeat grafts for young patients.
