Penetrating keratoplasty in Nepal.
OBJECTIVE
To identify indications and outcomes in a large series of penetrating keratoplasty surgeries performed in Nepal.


METHODS
A retrospective case series of 472 consecutive penetrating keratoplasty surgeries (408 patients) performed at Tilganga Eye Center, Kathmandu, Nepal from June 1994 to September 1999.


RESULTS
Mean recipient age was 39.2 years (+/- 19.7 years). Main indications for PKP were corneal scar (37%), adherent leukoma (35%), perforation or impending perforation (9%), pseudophakic bullous keratopathy (6%), keratoconus (4%), and aphakic bullous keratopathy (3%). Mean duration of follow-up was 27.6 +/- 25.1 months. Sixty-five percent of available grafts were clear at 6 months, and 70% of available grafts were clear at 3 years. Six months postoperatively, 15% of patients had acuity better than 6/18, 37% had acuity between 6/18 and 6/60, and 17.7% had acuity between 6/60 and 3/60. Common causes of graft failure were endothelial failure (43%), increased intraocular pressure (15%), ulcer (14%), and trauma (7%).


CONCLUSIONS
The corneal diseases and indications for transplant surgery in Nepal are different from those in the Western world. Despite these differences, penetrating keratoplasty is a successful and reasonable way to reduce corneal blindness in developing nations.
Tabin
Geoffrey C
GC
Department of Opthalmology, University of Vermont College of Medicine, Burlington 05401, USA. geoffrey.tabin@vtmednet.org
Gurung
Rita
R
Paudyal
Govinda
G
Reddy
Harsha S
HS
Hobbs
Cara L
CL
Wiedman
Michael S
MS
Ruit
Sanduk
S
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D003906:Developing Countries; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007223:Infant; D015948:Keratoplasty, Penetrating / Q000706:statistics & numerical data* / Q000639:trends; D019654:Lens Implantation, Intraocular / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D011183:Postoperative Complications; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology