Corneal graft surgery: A monocentric long-term analysis

Area of Science:

• Ophthalmology
• Transplantation Surgery
• Corneal Diseases

Background:

• Keratoplasty is a critical surgical intervention for corneal blindness.
• Understanding trends in keratoplasty indications and outcomes is essential for improving patient care.

Purpose of the Study:

• To investigate the indications, outcomes, and evolving clinical patterns of keratoplasty surgery.
• To analyze graft survival rates, failure causes, and visual results across different keratoplasty techniques.

Main Methods:

• Retrospective review of 907 corneal transplant records (2001-2017).
• Inclusion criteria: detailed preoperative data, surgical reports, and ≥12 months follow-up.
• Statistical analysis of indications, survival rates, graft failures, and visual outcomes.

Main Results:

• Penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), and endothelial keratoplasty (EK) were analyzed.
• Cumulative 1-year survival: 94% (PK) to 69% (EK); 5-year survival: 85% (PK) to 45% (EK).
• Rejection (PK), surface disease (DALK), and primary failure (EK) were main causes of graft loss. Visual function improved post-surgery for all techniques.

Conclusions:

• Corneal transplantation remains complex with significant failure risks.
• Lamellar keratoplasty techniques demonstrated superior success rates and visual outcomes compared to full-thickness grafts.
• Outcomes are highly dependent on indications and surgical methods, highlighting the need for technique-specific approaches.