J Korean Ophthalmol Soc.  2012 Oct;53(10):1397-1402.

Long-Term Outcomes of Penetrating Keratoplasty in Treating Macular Corneal Dystrophy, TGFBI Dystrophy, and Fuchs' Dystrophy

• Lee YK
• Kim MS

Abstract

PURPOSE
To compare long-term outcomes of penetrating keratoplasty in treating macular corneal dystrophy, transforming growth factor beta induced (TGFBI) dystrophy, and Fuchs' dystrophy.
METHODS
The present retrospective study describes the postoperative results of 123 eyes in 70 patients; 53 eyes with macular corneal dystrophy, 20 eyes with TGFBI dystrophy, and 50 eyes with Fuchs' dystrophy. All patients received penetrating keratoplasty. The outcome measures included recurrence rate, graft rejection, graft survival rate and corneal endothelial density and other complications.
RESULTS
As compared with the other groups, TGFBI dystrophy had the highest recurrence rate (p-value < 0.0001). Fuchs' dystrophy had the lowest graft survival rate (p-value = 0.03). Corneal endothelial cell density was lowest in Fuchs' dystrophy 10 years postoperatively (p-value = 0.0006), but there was no significant difference in corneal endothelial cell density between the 3 groups 1 and 5 years postoperatively. There was no significant difference between the 3 groups in other complications such as graft rejection, secondary glaucoma and persistent epithelial defect (p-value = 0.809, p-value = 0.584, p-value = 0.972, respectively).
CONCLUSIONS
Penetrating keratoplasty showed different long-term outcomes in treating 3 types of corneal dystrophies. The difficulty may depend on the pathogenesis of corneal dystrophies.

Keyword

Fuchs' dystrophy; Macular dystrophy; Penetrating keratoplasty; Transforming growth factor beta induced (TGFBI) dystrophy

MeSH Terms

Endothelial Cells
Eye
Fuchs' Endothelial Dystrophy
Glaucoma
Graft Rejection
Graft Survival
Humans
Keratoplasty, Penetrating
Macular Degeneration
Outcome Assessment (Health Care)
Recurrence
Retrospective Studies
Transforming Growth Factor beta
Fuchs' Endothelial Dystrophy
Transforming Growth Factor beta

Figure

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  Figure 1 Kaplan-Meier graph showing overall recurrence-free survival rate of penetrating keratoplasty in treating three corneal dystrophy groups. As compared with the other groups, TGFBI corneal dystrophy group had the highest recurrence rate (p-value < 0.0001).

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  Figure 2 Kaplan-Meier graph showing overall graft survival rate of penetrating keratoplasty in treating three corneal dystrophy groups. Fuchs' dystrophy had the lowest graft survival rate (p-value = 0.03).

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  Figure 3 Bar graph showing changes of corneal endothelial cell density of penetrating keratoplasty in treating three corneal dystrophy groups. Corneal endothelial cell density was lowest in Fuchs' dystrophy 10 years postoperatively (*p-value = 0.032), but there was no significant difference in corneal endothelial cell density between the 3 groups 1 and 5 years postoperatively.

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