This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Large, Single-Center Patient Cohort

Francis W. Price, Jr, MD; William E. Whitson, MD; Karen S. Collins, RN; Ronald G. Marks, PhD

Arch Ophthalmol. 1993;111(6):799-805.

Abstract
• Objective.
—To determine the survival rates and causes of secondary graft failure in a large, consecutive series of penetrating keratoplasties.

Design.
—All eyes undergoing penetrating keratoplasty at a single center were evaluated for factors relating to penetrating keratoplasty preoperatively, surgically, and postoperatively at 1, 3, 6, 9,12,18, and 24 months and then at yearly intervals. Since 1986, data analysis has been prospective.

Setting.
—A large, private practice, tertiary center for corneal disorders and surgery.

Patients.
—A consecutive series of 1819 penetrating keratoplasties performed from August 1982 through August 1990; 13 eyes with primary graft failure were excluded.

Main Outcome Measure.
—Graft failure and causes of failure. Follow-up ranged from 1 to 96 months, with a mean of 26.6 months.

Results.
—Pseudophakic bullous keratopathy was the most common diagnosis necessitating keratoplasty (38.6%). Secondary failures occurred 111 times (6.1%). The 2- and 5-year survival rates for all grafts in the study were 95% and 91%, respectively. While endothelial failure as a result of immunologic allograft reactions was the most common cause of graft failure (27%), problems with the external surface of the graft caused nearly as many failures (25%). The risk of failure from surface-related problems was highest at 3 months after surgery. There were significantly decreased survival rates for grafts in eyes with regrafts (P<.0001), in eyes left aphakic at keratoplasty (P<.0001), and in eyes with deep stromal vascularization (P<.0001).

Conclusion.
—Penetrating keratoplasty is a successful form of transplantation, and survival rates are gradually increasing. The risk of graft failure appears highest within the first year after transplantation.

Author Affiliations
From Corneal Consultants of Indiana (Drs Price and Whitson) and the Cornea Research Foundation of America (Ms Collins), Indianapolis, Ind; and the Department of Biostatistics, University of Florida, Gainesville (Dr Marks).

Footnotes
Accepted for publication March 15, 1993.

Reprint requests to Corneal Consultants of Indiana, Suite 100,9002 N Meridian St, Indianapolis, IN 46260 (Dr Price).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Mechanical Stability of Microkeratome-Assisted Intracorneal Keratoprosthesis Implantation
Erb et al.
Arch Ophthalmol 2004;122:1839-1843.
ABSTRACT | FULL TEXT  

Risk Factors for Various Causes of Failure in Initial Corneal Grafts
Price et al.
Arch Ophthalmol 2003;121:1087-1092.
ABSTRACT | FULL TEXT  

Corneal blindness in a southern Indian population: need for health promotion strategies
Dandona and Dandona
Br. J. Ophthalmol. 2003;87:133-141.
ABSTRACT | FULL TEXT  

Effect of Administration of CTLA4-Ig as Protein or cDNA on Corneal Allograft Survival
Comer et al.
IOVS 2002;43:1095-1103.
ABSTRACT | FULL TEXT  

Outcome of corneal transplantation: can a prioritisation system predict outcome?
Saunders et al.
Br. J. Ophthalmol. 2002;86:57-61.
ABSTRACT | FULL TEXT  

Donor organ cultured corneal tissue selection before penetrating keratoplasty
Borderie et al.
Br. J. Ophthalmol. 1998;82:382-388.
ABSTRACT | FULL TEXT  

Survival analysis and visual outcome in a large series of corneal transplants in India
Dandona et al.
Br. J. Ophthalmol. 1997;81:726-731.
ABSTRACT | FULL TEXT