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Comparative Study
. 2009 May-Jun;19(3):362-8.
doi: 10.1177/112067210901900306.

Repeat penetrating keratoplasty: indications and prognosis, 1995-2005

Zuleyha Yalniz-Akkaya  1 , Ayse Burcu Nurozler, Elvin Yildiz, Mustafa Onat, Koray Budak, Sunay Duman
Affiliations
Comparative Study

Repeat penetrating keratoplasty: indications and prognosis, 1995-2005

Zuleyha Yalniz-Akkaya et al. Eur J Ophthalmol. 2009 May-Jun.

Abstract

Purpose: To evaluate the data of penetrating keratoplasty over a 10-year period and to compare indications and outcomes of eyes undergoing single graft with those of eyes requiring regrafting.

Methods: A total of 652 eyes of 613 patients required single graft (Group I). Sixty-one regrafts were performed on 53 eyes (Group II). The mean follow-up time was 23.4+/-21.3 months (range 6-132 months). The results were evaluated for the following criteria: primary indications, allograft reactions, graft clarity, final postoperative visual acuity, and complications leading to reduction in vision.

Results: The most common indication was keratoconus (228 eyes; 35.0%) in Group I, and vascularized corneal scar (12 eyes; 22.6%) in Group II. Allograft reactions occurred in 96 eyes (14.7%) in Group I, and 17 eyes (32.0%) in Group II (p=0.001). At the end of the study period, 76.4% of patients in Group I had entirely clear grafts, whereas 45.3% of patients in Group II had entirely clear grafts (p=0.000). The main causes of corneal graft failure were irreversible allograft reaction, endothelial failure, and graft infection, which were all seen in higher percentage in the regraft group. A best-corrected visual acuity of 20/100 or better was achieved in 377 eyes (57.8%) in Group I and 11 eyes (20.7%) in Group II (p=0.000).

Conclusions: The complications of repeated surgery may reduce final graft clarity and visual acuity; the disease process necessitating regrafting may carry a poorer prognosis for sight.

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