title: Cataract formation and cataract extraction after penetrating keratoplasty.
abstract: OBJECTIVE
  This retrospective study was done to identify risk factors for cataract formation and cataract extraction after penetrating keratoplasty to determine whether a combined procedure (simultaneous cataract extraction with keratoplasty) or penetrating keratoplasty alone should be performed.
  
  
  METHODS
  Variables from 342 phakic eyes having undergone penetrating keratoplasties were studied with univariate and multivariate analyses, including diagnosis, race, sex, age, preoperative lens opacities, preoperative vision, and length of follow-up.
  
  
  RESULTS
  For cataract formation, age was the only independent risk factor found by multivariate analysis (P = 0.0001). For cataract extraction after penetrating keratoplasty, independent risk factors included age, sex, diagnosis, and preoperative lens opacities (P < or = 0.03). For example, the probability of a 65-year-old patient with Fuchs dystrophy requiring a cataract extraction within 5 years of keratoplasty is 81%.
  
  
  CONCLUSIONS
  The likelihood of cataract formation and cataract extraction subsequent to penetrating keratoplasty increases greatly after 50 years of age, regardless of the diagnosis leading to the need for keratoplasty. The need for cataract extraction also is increased for female patients, for patients with Fuchs dystrophy, and for those with early preoperative lens opacity.
authors.affiliation: Department of Ophthalmology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1033.
authors.forename: T P
authors.initials: TP
authors.lastname: Martin
authors.forename: J W
authors.initials: JW
authors.lastname: Reed
authors.forename: C
authors.initials: C
authors.lastname: Legault
authors.forename: S M
authors.initials: SM
authors.lastname: Oberfeld
authors.forename: B G
authors.initials: BG
authors.lastname: Jacoby
authors.forename: D D
authors.initials: DD
authors.lastname: Yu
authors.forename: A
authors.initials: A
authors.lastname: Dickens
authors.forename: H P
authors.initials: HP
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000209:etiology*; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity