Outcomes of same-sizing versus oversizing donor trephines in keratoconic patients undergoing first penetrating keratoplasty.
OBJECTIVE
To investigate whether use of same-size donor and recipient trephines reduced myopia after penetrating keratoplasty for keratoconus.


METHODS
Retrospective cohort study.


METHODS
Eight hundred seventy-eight first grafts for keratoconus were reported to UK Transplant between April 1999 and December 2003. There were 234 and 644 grafts in the same-size and oversize donor trephine groups, respectively. At 1 year, mean spherical equivalent (SE) data were available for 116 eyes (50%) and 295 eyes (46%) in the same-size and oversize groups. At 2 years, mean SE data were available for 64 eyes (27%) and 148 eyes (23%) in the same-size and oversize groups.


METHODS
Logistic regression and univariate analysis of follow-up data submitted to UK Transplant.


METHODS
At 1 and 2 years postoperatively, mean SE, magnitude of the cylindrical component of the refraction, postoperative uncorrected visual acuity (VA), postoperative best-corrected VA, and postoperative complications were recorded.


RESULTS
The mean SEs for the same-size and oversize donor trephine groups, respectively, were -1.45 diopters (D) and -1.41 D at 1 year (P = 0.6) and -1.74 D and -2.19 D at 2 years postoperatively (P = 0.3). Although there were no differences in graft survival between the groups at 1 and 2 years, there was a higher incidence of postoperative wound leaks in the same-size group (P = 0.03).


CONCLUSIONS
Use of same-size donor and recipient trephines did not reduce myopia and was associated with an increased risk of postoperative complications.
Jaycock
Philip D
PD
Bristol Eye Hospital, Bristol, United Kingdom. philipjaycock@hotmail.com
Jones
Mark N A
MN
Males
John
J
Armitage
W John
WJ
Cook
Stuart D
SD
Tole
Derek M
DM
Kaye
Stephen B
SB
D000328:Adult; D003315:Cornea / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D009216:Myopia / Q000517:prevention & control; D011183:Postoperative Complications; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome; D014792:Visual Acuity