Main issues in penetrating keratoplasty

Area of Science:

• Ophthalmology
• Corneal Surgery
• Transplantation Immunology

Background:

• Penetrating keratoplasty (PK) remains a key surgical intervention for corneal opacity.
• Graft rejection is a significant complication impacting long-term visual outcomes.
• Technological advancements are continually refining PK procedures and post-operative care.

Purpose of the Study:

• To review current challenges and advancements in penetrating keratoplasty (PK).
• To explore strategies for preventing graft rejection in PK.
• To highlight the role of PK in managing corneal pathologies, particularly keratoconus (KC).

Main Methods:

• Systematic literature search (January 2018 - July 2023) across major biomedical databases.
• Inclusion of studies on PK, its comparison with other corneal pathologies, and emphasis on KC.
• Data extraction and synthesis by two independent reviewers.

Main Results:

• Infra-red femtosecond lasers enhance PK graft shapes, reduce astigmatism, and improve wound healing.
• Risk factors, diagnostic techniques, and preventive measures for graft rejection are detailed.
• Effective postoperative care, including IOP monitoring and steroid use, is crucial.

Conclusions:

• A comprehensive approach involving topical and systemic medications is vital for preventing graft rejection.
• Monoclonal antibody research shows promise for future rejection management.
• Personalized strategies and ongoing research are expected to further improve PK outcomes.