Young AL, Kwok RP, Jhanji V, Cheng LL, Rao SK. Long-term outcomes of endothelial keratoplasty in Chinese eyes at a University Hospital.
EYE AND VISION 2014;
1:8. [PMID:
26858960 PMCID:
PMC4745171 DOI:
10.1186/s40662-014-0008-9]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 10/27/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND
Endothelial keratoplasty (EK) is used increasingly for the management of cases with endothelial dysfunction. Long-term outcomes of the surgery are not widely reported in the literature. We report our experience of EK in Chinese eyes at a University teaching hospital.
METHODS
Retrospective analysis was performed for all cases of EK performed between 2005 and 2009. Data analyzed included indication for surgery, associated surgical procedures, complications, best-corrected visual acuity (BCVA) and overall graft survival.
RESULTS
Overall, 22 eyes of 21 patients underwent EK (13 males, 8 females, mean age 71.8 ± 11.3 years). Pseudophakic bullous keratopathy was the leading indication for surgery (n = 12) followed by Fuchs' endothelial dystrophy (n = 4), or both (n = 3). Other indications for surgery included failed penetrating keratoplasty (n = 2) and endothelial decompensation due to multiple surgeries (n = 1). Triple procedure was performed in 5 (22.7%) cases. Complications were noted in the form of postoperative interface hemorrhage (n = 2, 9%) and graft dislocation (n = 1, 4.5%). The mean postoperative endothelial cell density was 1069 ± 585.8 cells/mm(2). The mean postoperative pachymetry was 675.8 ± 108.5 μm. The mean preoperative and postoperative intraocular pressure was 11.3 ± 3.2 and 13.9 ± 4.5 mmHg respectively. At the last follow-up (mean, 47.4 ± 13.7 months), BCVA was ≥20/70 in 9 (40.9%) cases. Causes of poor BCVA included primary graft failure (n = 4), graft decompensation (n = 4), advanced glaucoma (n = 2) and irreversible graft rejection (n = 2). Graft remained clear in 12 (54.5%) cases at the last follow-up. Average graft survival was 19.7 ± 17.7 months (median 17.5 months).
CONCLUSIONS
Nearly half of the EK grafts in our study survived over a period of five years. Graft failure, glaucoma and graft rejection were the main causes of poor graft survival.
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