Evaluation of Penetrating Keratoplasty Results: Initial Experiences

Abstract

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.

Keywords

• penetrating keratoplasty
• indications;
• complications

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