Long-term results of penetrating keratoplasty. A 10-year-plus retrospective study.
BACKGROUND
The aim of this study was to retrospectively analyse the outcome of a series of grafted patients over a period of more than 10 years and to determine their long-term survival probability.


METHODS
The records of 89 patients who had 103 grafts performed in 97 eyes were analysed. Mean follow-up was 12.8 years (range 10-17 years). Life table analysis (Kaplan-Meier) was used to evaluate the graft survival of the total population and of different groups.


RESULTS
Eighteen out of 89 patients (20.2%) had died. At the last visit before their death, 10 of the 21 grafts in those patients were still clear. Graft survival rates after 1, 2, 5 and 10 years were 79%, 73%, 59% and 50%; the rate at the end of follow-up was 47%. Survival rate at the end of the study was 94.7% for keratoconus, 57.1% herpes keratitis, 33.3% for pseudophakic keratopathies, 28.5% for post-traumatic keratopathies and 11.1% for re-grafts. In the group of patients grafted for aphakic or pseudophakic keratopathy, 40% died during the study. In 45% of cases their grafts were clear at the time of death. Endothelial decompensation and definitive graft rejection were the main causes of failure.


CONCLUSIONS
The outcome of keratoplasty is progressively getting worse with time in pseudophakic or traumatic keratopathies whereas survival rates are still stable from 10 to 17 years in grafts performed after keratoconus or herpetic keratitis.
Muraine
Marc
M
Department of Ophthalmology, Hospital Charles Nicolle, Boulevard Gambetta, 76031 , Rouen cedex, France. marc.muraine@chu-rouen.fr.
Sanchez
Christian
C
Department of Ophthalmology, Hospital Charles Nicolle, Boulevard Gambetta, 76031 , Rouen cedex, France.
Watt
Laure
L
Department of Ophthalmology, Hospital Charles Nicolle, Boulevard Gambetta, 76031 , Rouen cedex, France.
Retout
Alain
A
Department of Ophthalmology, Hospital Charles Nicolle, Boulevard Gambetta, 76031 , Rouen cedex, France.
Brasseur
Gérard
G
Department of Ophthalmology, Hospital Charles Nicolle, Boulevard Gambetta, 76031 , Rouen cedex, France.
D000293:Adolescent; D000328:Adult; D000368:Aged; D003316:Corneal Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005131:Eye Injuries / Q000150:complications; D005260:Female; D006085:Graft Survival; D006801:Humans; D016849:Keratitis, Herpetic / Q000601:surgery; D007640:Keratoconus / Q000601:surgery; D054018:Lasers, Excimer; D015993:Life Tables; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D014792:Visual Acuity