Majority of transplants still functioning at 10 years after PK

Cornea. 2009;28(10):1124-1129.

Ten-year follow-up of patients after penetrating keratoplasty showed that 71% of transplants were still functioning, with keratoconic patients showing the best results and bullous keratopathy patients the worst, a study found.

Of the 242 patients who received a corneal transplant from 1996 to 1998 in Sahlgrenska University Hospital in Sweden, 140 patients were available 10 years postop. The study authors analyzed these patients to learn more about the long-term outcomes by assessing graft survival and visual outcome, concluding that predicting factors of the long-term outcome of PK can be established 2 years after the operation.

Patients were divided into three indication groups: keratoconus, Fuchs' endothelial dystrophy, and pseudophakic or aphakic bullous keratopathy. Patients with regrafts, stromal dystrophies and scars were grouped as other. Eighty-eight percent of keratoconic patients and 79% of Fuchs' patients had functioning grafts at 10 years, as compared with 48% of patients in the bullous keratopathy group and 59% in the other group.

Complications during the first 2 postoperative years reduced the likelihood of having a functioning graft at 10 years, the study authors found. Half of the grafts that suffered complications failed by 10 years; 84% of grafts that did not suffer complications were still functioning at 10 years.

The majority of patients in all indication groups had a visual acuity of 0.2 or less preoperatively, and 70% of patients in the bullous keratopathy group retained that level at 10 years despite improvement at 2 years. The probability of reaching a visual acuity above 0.5 was influenced by indication and complications at 2 years. Regardless of indication, however, the authors noted that maximum visual potential was achieved within the first 2 years.