Abstract
Purpose To investigate long-term graft survival rates of penetrating keratoplasties, patient characteristics and co-morbidities in a single tertiary care centre on the South Coast.
Methods Retrospective, non-comparative case series review of 5-year follow-up for patients who underwent penetrating keratoplasty between 2008 and 2018. The primary outcome measures were 5-year corneal graft survival, graft surgery indications, and co-morbidities identification.
Results 198 penetrating keratoplasties were performed, of which 32 were excluded from further investigation because of insufficient follow-up data. 60 (36%) grafts in 45 patients did not survive a 5-year follow-up. In this group, the mean age of transplant recipients was 64 years (range 18–90, median 67), with a male-to-female ratio of 5:4. 27 (45%) were re-graft surgeries, and 10 (17%) had more than three penetrating keratoplasties. The failure group often included more than one indication for surgery. Of these, the most prevalent were infective/therapeutic grounds (52%), bullous keratopathy (20%), herpes simplex keratitis (10%), corneal ectasia (8%) and trauma-related (5%). The most common co-morbidities in the graft failure group were glaucoma (47%), infectious keratitis (42%), glaucoma surgery (20%), anterior chamber intraocular lens (13%) and retinal detachment surgery (13%). Most patients in the failure group (78%) were of advanced age of more than 65 years old.
Conclusions It was found that most penetrating keratoplasties failed due to infective keratitis. Patients in our graft failure group had high rates of ocular and medical co-morbidities, requiring multiple procedures and multidisciplinary care from various ophthalmic and medical subspecialties.
