An analysis of corneal transplantation: I--graft clarity

A retrospective review has been undertaken of the clarity results of 378 keratoplasties performed by 6 Toronto corneal surgeons between January 1970 and December 1974. Lamellar keratoplasties were included in the data related to herpes simplex only. In herpes simplex penetrating grafts gave better vision than lamellar grafts. The following factors were statistically important with respect to graft clarity: age of recipient, type of corneal disease, peroperative corneal vessels, first or subsequent graft, pre- and/or postoperative glaucoma, postoperative anterior synechiae, combined procedure, vitreous loss, previous cataract surgery, and follow-up time. The following factors were statistically unimportant with respect to graft clarity: donor age, time from death to enucleation (median 2.8 hours), time from enucleation to use (median 24 hours), sex of donor and recipient, interrupted or running suture, use of microscope, penetrating or lamellar graft in herpes simplex, postoperative astigmatism, and division of postoperative anterior synechiae. Silk (compared with nylon), larger grafts and combined procedures all increased the incidence of graft rejection. Repeat grafts were associated with more preoperative corneal vascularization.