Evaluation of Penetrating Keratoplasty Results: Initial Experiences

Evaluation of Penetrating Keratoplasty Results: Initial Experiences

Aim: It is aimed to examine the indication distributions and clinical results of penetrating keratoplasties (PKP) performed with the first experience of surgeons in a center where PKP was started for the first time. Material and Method: In this retrospective study, 64 eyes of 63 patients who underwent PKP at Van Training and Research Hospital between 2017 and 2020 were evaluated. Demographic characteristics, PKP indications, and additional pathologies of the patients were obtained from the files of the patients and their records in the Van Training and Research Hospital eye bank. In addition, preoperative, postoperative first, third, and sixth-month visual acuities of the patients were evaluated, and postoperative complications were examined. The surgeries were performed by three different surgeons (EM, MSD, YE) who had just started performing PKP. Results: Penetrating keratoplasty indications are respectively pseudophakic bullous keratopathy (32.8%), keratoconus (17.1%), corneal scar due to previous herpes keratitis (14%), corneal dystrophy (10.9%), aphakic bullous keratopathy (9.3%), traumatic scar (9.3%), graft with rejection reaction (4.6%), and a corneal abscess that did not regress with medical treatment (1.5%). Postoperative complications were glaucoma (9.3%), rejection reaction (7.8%), cataract (6.2%), suture loosening (4.6%), keratitis (3.1%), traumatic perforation (1.5%) and endophthalmitis (1.5%). There was a statistically significant increase in visual acuity in the first, third, and sixth months compared to the preoperative value (for all; p<0.01). However, there was no significant increase in visual acuity in the sixth postoperative month compared to the third month (p>0.05). Conclusion: The most common indication for PKP was pseudophakic bullous keratopathy. In this patient series, which consisted of the first experiences of surgeons, the postoperative complication rate was 34.3%. Despite this, a significant improvement in visual acuity and graft survival was achieved in 95.3% of patients in early postoperative follow-ups.

___

  • 1. Whitcher JP, Srinivasan M, Upadhyay P. Corneal blindness a global perspective. Bull World Health Org. 2001;79(3):21421.
  • 2. Çubuk M, Koçluk Y, Özelbaykal B. Indication distributions and clinical results in penetrating keratoplasy cases. Turkiye Klinikleri J Ophthalmol. 2019;28(4):273–80
  • 3. Matthaei M, Sandhaeger H, Hermel M, Adler W, Jun AS, Cursiefen C, et al. Changing Indications in Penetrating Keratoplasty: A Systematic Review of 34 Years of Global Reporting. Transplantation. 2017;101(6):1387–99.
  • 4. Niederkorn JY. The immune privilege of corneal grafts. J Leukoc Biol. 2003;74(2):167–71.
  • 5. Stechschulte SU, Azar DT. Complications after penetrating keratoplasty. Int Ophthalmol Clin. 2000;40(1):27–43.
  • 6. Öndaş O, Keleş S, Bozkurt E. Aetiology, Outcomes And Prognosis Of Penetrating Keratoplasty Performed On Patients Aged Above 65 Years. Turkish Journal of Geriatrics. 2019; 22(1): 56–65.
  • 7. Arıkan G, Durak İ, Yaman A, Özbek Z. Penetrating keratoplasty in children. Türk Oftalmoloji Gazetesi 2006;36:197–202.
  • 8. Bayden Ö, Torun Acar B, Acar S. Pediatric Keratoplasty Indications and Outcomes. MN Ophthalmol 2012;19(2):818.
  • 9. Tanyıldız B, Goktaş E, Tutaş Gunaydın N, Kandemir B. Clinical Findings and Visual Outcomes of Patients Who Underwent Urgent Keratoplasty. MN Ophthalmol 2020;27(2):75–80.
  • 10. Nurözler AB, Özkan G, Onat M, Budak K, Örnek F. The Results of Tectonic Keratoplasty. MN Ophthalmol 2008;15(3):15762.
  • 11. Abdelaal AM, Alqassimi AH, Malak M, Hijazi HT, Hadrawi M, Khan MA. Indications of Keratoplasty and Outcomes of Deep Anterior Lamellar Keratoplasty Compared to Penetrating Keratoplasty. Cureus. 2021;13(3):e13825.
  • 12. Dasar L, Pujar C, Gill KS, Patil M, Salagar M. Indications of penetrating keratoplasty in southern India. J Clin Diagn Res. 2013 Nov;7(11):2505–7.
  • 13. Zhang AQ, Rubenstein D, Price AJ, Côté E, Levitt M, Sharpen L, et al. Evolving surgical techniques of and indications for corneal transplantation in Ontario: 2000 – 2012. Can J Ophthalmol. 2013;48(3):153–9.
  • 14. Koppen C, Kreps EO, Anthonissen L, Van Hoey M, Dhubhghaill SN, Vermeulen L. Scleral Lenses Reduce the Need for Corneal Transplants in Severe Keratoconus. Am J Ophthalmol. 2018;185:43–7.
  • 15. Anshu A, Price MO, Price FW Jr. Risk of corneal transplant rejection significantly reduced with Descemet’s membrane endothelial keratoplasty. Ophthalmology. 2012;119(3):53640.
  • 16. Yildiz EH, Hoskins E, Fram N, Rapuano CJ, Hammersmith KM, Laibson PR, et al. Third or greater penetrating keratoplasties: indications, survival, and visual outcomes. Cornea. 2010;29(3):254–9.
  • 17. Altay Y, Burcu A, Aksoy G, Ozdemir ES, Ornek F. Changing indications and techniques for corneal transplantations at a tertiary referral center in Turkey, from 1995 to 2014. Clin Ophthalmol. 2016;10:1007–13.
  • 18. Muhafiz E. Advances in Non-surgical Treatment Methods in Vision Rehabilitation of Keratoconus Patients. In: Ziaei A, Lanza M, ed. Eyesight and Imaging – Advances and New Perspectives [Internet]. London: IntechOpen; 2021.
  • 19. Akyol F, Küçökgül S, Bayata A, Akkaya A, Çakmaklı Z. Penetrating keratoplasty results in İzmir Atatürk State Hospital. T Klin J Ophthalmol 1996;5:312–319.
  • 20. Boisjoly HM, Bernard PM, Dubé I, Laughrea PA, Bazin R, Bernier J. Effect of factors unrelated to tissue matching on comeal transplant endothelial rejection. Am J Ophthalmol. 1989;107(6):647–54.
  • 21. Thompson RW Jr, Price MO, Bowers PJ, Price FW Jr. Long-term graft survival after penetrating keratoplasty. Ophthalmology. 2003;110(7):1396–402.
  • 22. Muraine M, Sanchez C, Watt L, Retout A, Brasseur G. Long-term results of penetrating keratoplasty. A 10-yearplus retrospective study. Graefes Arch Clin Exp Ophthalmol. 2003;241(7):571–6.
Kafkas Journal of Medical Sciences-Cover
  • ISSN: 2146-2631
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2011
  • Yayıncı: Kafkas Üniversitesi
Sayıdaki Diğer Makaleler

The Importance of Intense Pain Management for the Treatment Success of Extracorporeal Shock Wave Lithotripsy

Deniz İPEK

Analysis of PD-L1 Immunohistochemistry Results for Different Sampling Procedures of Non-small Cell Lung Carcinoma. Can We Use Cell Blocks for Evaluation of PD-L1?

Esin KAYMAZ, Haldun UMUDUM

The Cognitive Benefits of Playing Volleyball: A Systematic Review

Evrim GÖKÇE, Emel GUNES, Erhan NALÇACI

Evaluation of the Relationship Between Mitral Annular Calcification and CRP/albumin Ratio

Kürşat AKBUĞA, Hatice KAYIKCIOĞLU

Evaluation of Penetrating Keratoplasty Results: Initial Experiences

Mehmet Siraç DEMİR, Ersin MUHAFİZ, Yusuf EVCİMEN

The Role of Endosonography in Patients With Moderate and High Probability of Choledocholithiasis

Rasim Eren CANKURTARAN, Zahide ŞİMŞEK, Yusuf COŞKUN

Does Subclinical Hypothyroidism Alter the Axis of QRS and P Waves?

Timor OMAR, Metin ÇAĞDAŞ, Mahmut YESİN, Doğan ILİS, Muammer KARAKAYALI, İnanc ARTAC, Mustafa AVCI, Hikmet Utku ODMAN, Yavuz KARABAĞ, Ibrahim RENCÜZOĞULLARI

Past to Present, Epidemiology of SARS-CoV-2 Infection and Ways of Treatment: A Review

Orhan ULUÇAY, Elif ALTUNKÜLAH, Ünal ALKAŞİ

Examination of Primary School Students’ Knowledge of the Flu and the Factors Affecting Their Decision to Get Flu Vaccines

Gonul GOKCAY, Dogan AKCA

Online Tools and Instructional Methods Used in Distance Learning on the Motivation and Attitudes of Nursing Students During COVID-19 Pandemic: A Cross-sectional Study

Arife ŞANLIALP ZEYREK, Özlem FİDAN, Sümeyye ARSLAN