Postoperative complications after primary adult optical penetrating keratoplasty: prevalence and impact on graft survival.
OBJECTIVE
To evaluate the prevalence of postoperative complications and their impact on graft survival after primary adult optical penetrating keratoplasty (PKP).


METHODS
A retrospective review was done of consecutive cases of PKP performed between January 1, 1997, and December 31, 2001, for keratoconus, corneal edema, stromal scarring, and stromal dystrophy.


RESULTS
The inclusion criteria were met by 910 eyes, including 464 with keratoconus, 188 with corneal edema, 175 with stromal scarring, and 83 with stromal dystrophy. One or more complications occurred in 362 eyes (39.8%). The most common complication was endothelial rejection (17.3%), followed by glaucoma worsening (15.5%), bacterial keratitis (5.8%), persistent epithelial defects (3.4%), and wound dehiscence (1.6%). There were significant differences among the surgical groups in overall prevalence of complications (P < 0.001) and with the prevalence of endothelial rejection (P = 0.01), glaucoma worsening (P < 0.001), bacterial keratitis (P = 0.04), and persistent epithelial defects (P = 0.02). Complication-associated graft failure varied significantly among the surgical groups (P = 0.02).


CONCLUSIONS
The prevalence of post-PKP complications and their impact on graft survival vary significantly among surgical indications for primary adult optical PKP.
Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. michael-wagoner@uiowa.edu
Michael D
MD
Wagoner
Rola
R
Ba-Abbad
Mansour
M
Al-Mohaimeed
Samar
S
Al-Swailem
M Bridget
MB
Zimmerman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003315:Cornea / Q000502:physiology*; D003316:Corneal Diseases / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult