How successful is corneal transplantation? A report from the Australian Corneal Graft Register.
Corneal graft outcome was assessed within a large, prospectively collected database of 4499 records. Penetrating corneal graft survival was 91% at 1 year, 72% at 5 years and 69% at 7 years. The three most common indications for graft were keratoconus (30%), bullous keratopathy (25%) and failed previous graft (18%); the three most common causes of graft failure were rejection (34%), infection (18%) and glaucoma (9%). The vast majority of grafts were performed for improved visual acuity. About four-fifths of recipients achieved at least one line of better acuity on the Snellen chart post-operatively; of the remainder with unchanged or worse acuity, only 21% had failed grafts. Overall, 43% of recipients achieved a best corrected Snellen acuity of 6/12 or better, 52% achieved 6/18 or better, and 20% had acuitities of less than 6/60. Reasons for poor post-operative acuity (recorded as less than 6/60) included graft failure (41%) and comorbidities in the grafted eye (43%). A number of risk factors for graft failure were examined: in most instances, there was little room for decision-making or expert intervention.
Williams
K A
KA
Department of Ophthalmology, Flinders University of South Australia, Adelaide.
Muehlberg
S M
SM
Lewis
R F
RF
Coster
D J
DJ
D001251:Astigmatism / Q000601:surgery; D001315:Australia; D016039:Corneal Transplantation / Q000706:statistics & numerical data; D006085:Graft Survival; D006801:Humans; D007640:Keratoconus / Q000601:surgery; D007910:Lenses, Intraocular; D009798:Ocular Hypertension / Q000150:complications; D011183:Postoperative Complications; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity