J Korean Ophthalmol Soc.  2012 Oct;53(10):1425-1431.

Long Term Clinical Results of Penetrating Keratoplasty for Macular Corneal Dystrophy

• Lee JM
• Hwang KY
• Hwang HS
• Kim MS

Abstract

PURPOSE
To report the long term clinical results of penetrating keratoplasty as a treatment for corneal macular dystrophy.
METHODS
Retrospective review of the medical record of 46 eyes (31 indivisuals) who underwent primary PK for corneal macular dystrophy at the Seoul St. Mary's Hospital between November, 1986 and December, 2011. Data extracted preoperative and postoperative best-corrected visual acuity (BCVA), postoperative complications (including graft rejection episodes, and recurrent dystrophy), change of endothelial cell density at 1, 6, 12, 24, 36 months and yearly thereafter.
RESULTS
After a mean follow-up period of 91.59 +/- 3.2 months, the mean BCVA was significantly improved after penetrating keratoplasty. Endothelial cell loss rate was marked during the 1st year after penetrating keratoplasty. Graft survival was 40 graft (89.7%) at 8yrs. There was a statistically significant increased likelihood of graft failure if the patient was older than 40 years at the time of surgery (p = 0.03). Glaucoma as postoperative complication was 17.4%. Clinically significant recurrence was 2%.
CONCLUSIONS
Penetrating keratoplasty is associated with a good visual outcome and prognosis for graft survival of long-term efficacy with a low complication rate in eyes with macular corneal dystrophy.

Keyword

Corneal macular dystrophy; Penetrating keratoplasty

MeSH Terms

Corneal Dystrophies, Hereditary
Endothelial Cells
Eye
Follow-Up Studies
Glaucoma
Graft Rejection
Graft Survival
Humans
Keratoplasty, Penetrating
Medical Records
Postoperative Complications
Prognosis
Recurrence
Retrospective Studies
Transplants
Visual Acuity

Figure

• 

  Figure 1 Change of data during post-operative follow Up. (A) The mean BCVA was significantly improved after penetrating keratoplasty. Mean BCVA was 0.78 ± 0.21 for 1 month, 0.46 ± 0.15 for 6 month, 0.38 ± 0.12 for 12 month, 0.36 ± 0.17 for 24 month, 0.35 ± 0.17 for 48 month (log MAR) (B) Rate of endothelial cell loss based on preoperative donor endothelial cell density. Post-operative endothelial cell loss rate was 33.43 ± 21.65% for 12 month, 44.44 ± 18.94% for 24 month, 56.79 ± 19.42% for 36 month. (C) There was change of corneal thickness during each period: 597 ± 42.9 for 1 month, 592 ± 35.6 for 6 month, 543 ± 39.2 for 12 month, 522 ± 13.4 for 24 month, 559.1 ± 27.6 for 48 month, 536 ± 18.9 for 60 month (µm). (D) There was change of graft survival rate during each period. The survival rate was 98.2% for 1yr, 97.3% for 2 yr, 94.6% for 4 yr, 92.1% for 6 yr, 89.7% for 8 yr. BCVA = best-corrected visual acuity.

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