title: Penetrating keratoplasty for unilateral corneal disease: outcomes from a tertiary care hospital in Australia.
abstract: OBJECTIVE
  To assess the visual outcome after unilateral penetrating keratoplasty (PKP) in a heterogenous group of patients with unilateral corneal disease.
  
  
  METHODS
  A retrospective analysis of hospital records of patients who had undergone PKP at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia, over a 10-year period, was performed. All cases with a history of corneal transplantation surgery in one eye and a best-corrected visual acuity (BCVA) more than or equal to 0.5 in the fellow eye with no corneal pathologic condition were included. Outcome measures included BCVA at 2 years, and overall graft survival.
  
  
  RESULTS
  Of the 498 grafts performed during the study period, 30 eyes (6%) met the inclusion criteria. The most common indications for PKP in the study group were bullous keratopathy (40%) and keratoconus (34%). The mean postoperative BCVA at 2 years (0.31 +/- 0.25; range, 0.033-1) was less than the mean BCVA of the fellow eye (0.77 +/- 0.20; range, 0.5-1) (P<0.00). Although there was a significant difference between the preoperative and postoperative BCVA (P<0.00), only 22% of patients could attain BCVA of more than or equal to 0.5. The major complications encountered were graft rejection (40%) and secondary graft failure (20%).
  
  
  CONCLUSIONS
  Unilateral PKP is most commonly performed to treat bullous keratopathy and keratoconus in Australia and may be associated with suboptimal visual outcome as compared to the normal fellow eye.
authors.affiliation: Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Sonia
authors.initials: S
authors.lastname: Moorthy
authors.forename: Marios
authors.initials: M
authors.lastname: Constantinou
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Beltz
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria; D014792:Visual Acuity; D055815:Young Adult