Repeat penetrating keratoplasty: indications and prognosis, 1995-2005.
OBJECTIVE
To evaluate the data of penetrating keratoplasty over a 10-year period and to compare indications and outcomes of eyes undergoing single graft with those of eyes requiring regrafting.


METHODS
A total of 652 eyes of 613 patients required single graft (Group I). Sixty-one regrafts were performed on 53 eyes (Group II). The mean follow-up time was 23.4+/-21.3 months (range 6-132 months). The results were evaluated for the following criteria: primary indications, allograft reactions, graft clarity, final postoperative visual acuity, and complications leading to reduction in vision.


RESULTS
The most common indication was keratoconus (228 eyes; 35.0%) in Group I, and vascularized corneal scar (12 eyes; 22.6%) in Group II. Allograft reactions occurred in 96 eyes (14.7%) in Group I, and 17 eyes (32.0%) in Group II (p=0.001). At the end of the study period, 76.4% of patients in Group I had entirely clear grafts, whereas 45.3% of patients in Group II had entirely clear grafts (p=0.000). The main causes of corneal graft failure were irreversible allograft reaction, endothelial failure, and graft infection, which were all seen in higher percentage in the regraft group. A best-corrected visual acuity of 20/100 or better was achieved in 377 eyes (57.8%) in Group I and 11 eyes (20.7%) in Group II (p=0.000).


CONCLUSIONS
The complications of repeated surgery may reduce final graft clarity and visual acuity; the disease process necessitating regrafting may carry a poorer prognosis for sight.
Yalniz-Akkaya
Zuleyha
Z
Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey. zyalniz@yahoo.com
Burcu Nurozler
Ayse
A
Yildiz
Elvin
E
Onat
Mustafa
M
Budak
Koray
K
Duman
Sunay
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000503:physiopathology; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012086:Reoperation; D014792:Visual Acuity / Q000502:physiology