Corneal re-graft: indications and outcome

Area of Science:

• Ophthalmology
• Corneal Surgery
• Transplantation Immunology

Background:

• Repeat penetrating keratoplasty (PKP) is a complex procedure.
• Understanding outcomes of repeat PKP is crucial for patient management.
• Previous studies have varied in their focus on indications and outcomes for repeat grafts.

Purpose of the Study:

• To evaluate the outcomes of repeat penetrating keratoplasty over a 10-year period.
• To compare indications and visual results of repeat PKP with primary PKP.
• To identify factors influencing graft clarity and visual success in repeat corneal transplants.

Main Methods:

• Retrospective analysis of 62 repeat penetrating keratoplasties (41 eyes) over 10 years.
• Review of indications for primary and repeat grafts, including herpes simplex keratitis, bullous keratopathy, and Fuch's dystrophy.
• Assessment of graft clarity, visual acuity, and reasons for graft failure.

Main Results:

• At study end, 68% of repeat grafts were clear, and 68% of eyes showed visual improvement.
• Common graft failure causes included rejection, endothelial failure, and recurrent conditions.
• Eyes undergoing primary PKP had better final visual results than those requiring repeat surgery, with keratoconus being a more frequent indication for single grafts.

Conclusions:

• Repeat penetrating keratoplasty can achieve encouraging graft clarity and visual outcomes.
• While outcomes are positive, primary keratoplasty generally yields superior visual results.
• Understanding indications for repeat grafts aids in managing expectations and surgical planning.