Cataract formation after penetrating keratoplasty

Area of Science:

• Ophthalmology
• Corneal Surgery
• Cataract Research

Background:

• Penetrating keratoplasty (PKP) is a common surgical procedure for corneal blindness.
• Cataract development is a known complication following PKP, impacting visual outcomes.
• Identifying risk factors is crucial for improving patient management and prognosis.

Purpose of the Study:

• To determine the incidence of cataract formation after PKP.
• To identify preoperative, intraoperative, and postoperative risk factors associated with cataract development post-PKP.

Main Methods:

• Retrospective analysis of 251 phakic patients undergoing PKP.
• Patients categorized into two groups based on corneal pathology: keratoconus/corneal dystrophy and corneal scar/adherent leucoma.
• Assessment of intraoperative iris procedures and postoperative topical steroid use.

Main Results:

• Of 184 eligible patients, 45 (24.45%) developed cataract, predominantly within the first year.
• Higher cataract incidence observed in patients with corneal scar/adherent leucoma compared to keratoconus/corneal dystrophy (P = .0102).
• Increased mean topical steroid dose in eyes with cataracts (P = .0352) and a higher incidence of cataract in patients undergoing intraoperative iris manipulations.

Conclusions:

• Excessive topical steroid use is a significant risk factor for post-PKP cataract.
• Intraoperative iris manipulations, including synechiolysis and pupilloplasty, are associated with increased cataract formation.
• These findings highlight the need to minimize steroid exposure and avoid iris trauma during PKP.