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Survival rate of corneal transplants for keratoconus high 20 years postop
Corneal allografts for keratoconus failed frequently after 2 years, but the likelihood of failure decreased by 20 years after surgery, according to a study.
The retrospective case series included 219 eyes of 184 patients who underwent corneal transplantation for keratoconus between 1980 and 1986. Average patient age at the time of surgery was 36.8 years. The average age of donors was 38.9 years.
Mean postoperative follow-up was 10.6 years. Patients underwent ophthalmic examinations, and some answered the National Eye Institute Visual Function Questionnaire (NEI VFQ).
Study results showed graft rejection in 98 of 219 grafts; the probability of rejection in the first 2 years after surgery was 41%.
Keratoconus recurred in six grafts 9 to 20 years after surgery; the 20-year probability of recurrence was 10%.
There were 18 graft failures; the 20-year probability of failure was 12%.
Larger size of the host trephine, male donors and non-white donors most strongly correlated with increased risk of rejection. Greater astigmatism and non-white recipients most strongly correlated with increased risk of failure.
Twenty-eight patients completed the NEI VFQ an average of 22.6 years after surgery. The mean composite score was 84.5 on a scale of 0 to 100, with higher scores meaning better functioning.