title: Indications for penetrating keratoplasty and associated procedures, 1989-1995.
abstract: OBJECTIVE
  To identify changing trends in indications for penetrating keratoplasty and associated surgical procedures.
  
  
  METHODS
  Review of charts from all patients who underwent penetrating keratoplasty at Wills Eye Hospital from January 1, 1989 through December 31, 1995.
  
  
  RESULTS
  A total of 2,442 corneal transplants were performed in 2,186 patients. The leading indication for penetrating keratoplasty was pseudophakic corneal edema, accounting for 634 cases (26.0%); 54.7% of them were associated with anterior chamber intraocular lenses, 36.4% with posterior chamber intraocular lenses, and 3.1% with iris-fixated intraocular lenses. Regraft (17.8%), Fuchs' dystrophy (15.7%), and keratoconus (13.2%) followed pseudophakic corneal edema in frequency. Cataract extraction, with or without intraocular lens implantation, was combined with penetrating keratoplasty in 439 cases of 1,264 phakic eyes (34.7%). Intraocular lens exchange was performed in 285 of the 634 cases of pseudophakic corneal edema (44.9%).
  
  
  CONCLUSIONS
  Pseudophakic corneal edema was the leading indication for penetrating keratoplasty, with an increasing number of cases associated with posterior chamber intraocular lenses during the study period (p = 0.001). The number of regrafts steadily increased between 1989 and 1995 (p = 0.001), being the second most common indication for corneal transplantation since 1992.
authors.affiliation: Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
authors.forename: N
authors.initials: N
authors.lastname: Lois
authors.forename: V O
authors.initials: VO
authors.lastname: Kowal
authors.forename: E J
authors.initials: EJ
authors.lastname: Cohen
authors.forename: C J
authors.initials: CJ
authors.lastname: Rapuano
authors.forename: J A
authors.initials: JA
authors.lastname: Gault
authors.forename: I M
authors.initials: IM
authors.lastname: Raber
authors.forename: P R
authors.initials: PR
authors.lastname: Laibson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D003316:Corneal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D015948:Keratoplasty, Penetrating / Q000009:adverse effects / Q000379:methods / Q000639:trends; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014821:Vitrectomy