Evaluation of Graft Clarity Post-penetrating Keratoplasty
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 1
Abstract
Introduction: Penetrating keratoplasty (PK) is the most commonly performed method of corneal transplantation. It is performed for central deep opacities in the visual axis, keratoconus, and disorders affecting the corneal endothelium resulting in cornea edema and loss of corneal clarity. Materials and Methods: A prospective, clinical study was carried out at D. Y. Patil Medical College, Navi Mumbai, which included 50 patients who were planned to undergo a full thickness PK for various corneal pathologies. Pre-operative investigations and examinations were conducted and informed written consent was taken before the procedure. A full thickness PK was performed. Postoperative follow-up was done on day 1, day 7, day 28, monthly up to 3 months and 3 monthly up to 1 year. The post-operative visual acuity, clarity of the graft, and complications encountered were compared. Results: Of the 50 patients included in the study, 23 patients underwent only PK surgery, 10 patients underwent the triple procedure (PK + cataract extraction + intraocular lens implantation), and 17 patients underwent PK with other procedures. On subsequent follow-up at day 28, there was a clear graft in 41 patients (82%). There was epithelial graft rejection in 1 patient (2%) of Steven Johnsons Syndrome. There was endothelial graft rejection in 2 patients (4%) of viral corneal ulcer and previous failed graft. There was glaucoma in 1 patient (2%). Severe astigmatism was noticed in 24 patients (48%). At the end of 1 year, we lost one patient to follow-up. Among the 49 patients, there was a clear graft in 35 patients (70%). There was glaucoma in 2 patient (4%). Severe astigmatism with a clear graft was noticed in 6 patients (12%). There was endothelial graft rejection in 10 patients (20%). Conclusion: The short-term success and survival of corneal grafts in this part of the developing world are reasonably good. By taking care of the pre- and post-operative factors responsible for graft rejection, our study has validated the normally accepted facts regarding outcome and survival of corneal grafts. Age, gender, indications for surgery, corneal graft diameter, and intraoperative vitreous loss had no significant effects on the outcome.
Authors and Affiliations
Nita Shanbhag
Keywords
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