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Resolved corneal hydrops not a major factor in graft survival, vision after PK
Penetrating keratoplasty yielded high graft survival rates and positive visual outcomes in eyes with keratoconus and resolved corneal hydrops, a study found.
“We found that despite higher chances of endothelial rejection episodes in eyes with prior corneal hydrops, especially those with active ocular allergy and longer duration of hydrops, allograft failure was rare and the visual outcomes of PK in the long run were excellent,” the study authors said.
The authors retrospectively reviewed the charts of 102 eyes of 102 patients with keratoconus who underwent PK. Mean patient age at the time of surgery was 20.4 years. Thirty-two patients had prior corneal hydrops; these patients had acute hydrops at a mean age of 19.6 years. The mean interval between resolution of hydrops and PK was 11.2 months.
Mean postoperative follow-up was 5.5 years.
Study results showed that eyes with resolved hydrops had endothelial rejection-free graft survival rates of 93.7% at 1 year and 82.6% at 5 years. Eyes without a history of hydrops had a survival rate of 100% at 1 year and 98% at 5 years; the between-group difference was statistically significant (P = .04).
Eyes with longer duration of hydrops and concomitant ocular allergy had a significantly greater risk of endothelial rejection (P = .019 and P = .012, respectively).
Endothelial rejection occurred in seven eyes; all were resolved with medication. No eyes had epithelial or stromal rejection. One eye had allograft failure after acute postoperative endophthalmitis with graft melting, the authors said.