Original articlesCorneal endothelium and postoperative outcomes 15 years after penetrating keratoplasty
Section snippets
Methods
The cohort consists of 500 consecutive patients who had penetrating keratoplasty performed by one surgeon (W.M.B.) between 1976 and 1986. Thirty-six repeat grafts and 70 fellow eyes were excluded from the study, leaving 394 grafts in 394 patients (i.e., 394 independent observations) available for analysis to 10 years after surgery. For the 15-year data, 6 patients had withdrawn research authorization, leaving 388 grafts available for analysis. There were 141 (36%) male and 247 (64%) female
Results
Of the 394 patients from the original analysis, 84% of the grafts were for Fuchs’ dystrophy, keratoconus, or corneal edema from aphakia or pseudophakia (Table 1). Sixty-seven patients (30% of the clear grafts available for follow-up) returned for their 15-year postoperative examination. At 15 years, 76 grafts were known to have failed and 107 patients were known to have died, reducing the overall cohort by 164 because 19 graft failures and deaths occurred in the same patients (Table 2). A
Discussion
From the original 394 patients in this cohort who underwent penetrating keratoplasty by the same surgeon, 67 attended for a 15-year follow-up examination. Although the 67 patients only represent 30% of the cohort presumed alive and without graft failure, these data are valuable in the long-term prospective evaluation of the corneal endothelium and outcomes after penetrating keratoplasty and represent the largest such cohort in the literature. Although the patients who did not return at 15 years
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Supported in part by National Institutes of Health grant EY 02037 (W.M.B.), and Research to Prevent Blindness, Inc., New York, New York.