Changing trends in the indications for penetrating keratoplasty
N. Mamalis, C. W. Anderson, K. R. Kreisler, M. K. Lundergan and R. J. Olson
Intermountain Ocular Research Center, University of Utah School of Medicine, Salt Lake City.
The indications for penetrating keratoplasty have changed over the past
several years. Nine hundred ninety-nine penetrating keratoplasty specimens
from 1981 through 1990 were analyzed. Overall, keratoconus was the most
common indication for penetrating keratoplasty (24.2%). This was followed
by pseudophakic bullous keratopathy (23.0%), regraft (13.1%), scarring
(8.2%), and Fuchs' endothelial dystrophy (5.8%). Pseudophakic bullous
keratopathy was the most common indication for penetrating keratoplasty in
each year from 1984 through 1989 with a peak in 1987 (33%). Since 1987, the
number of pseudophakic bullous keratopathy cases has decreased; and in
1990, keratoconus (33.1%) surpassed pseudophakic bullous keratopathy
(24.1%) as the most common indication for penetrating keratoplasty. This
decreasing incidence of pseudophakic bullous keratopathy may reflect the
discontinued use of closed-looped anterior chamber and iris-plane
intraocular lenses most commonly associated with this complication.
