title: The New Zealand National Eye Bank: survival and visual outcome 1 year after penetrating keratoplasty.
abstract: OBJECTIVE
  To identify potential donor, recipient, surgical, and postoperative factors that may influence survival and visual outcome of penetrating keratoplasty (PKP).
  
  
  METHODS
  As part of a prospective longitudinal study, the electronic records of the New Zealand National Eye Bank were analyzed for the 10-year period from 1994-2003. Both univariate and multivariate analysis was performed.
  
  
  RESULTS
  During the study period, the New Zealand National Eye Bank supplied 1820 corneas for PKP and 1629 (90%) had 1-year follow-up data. Overall, the 1-year survival rate was 87% (n = 1429). Donor factors including age, donor source, cause of death, death-to-preservation interval, endothelial cell density, donor lens status, and storage duration, were not significantly associated with decreased survival. The leading cause of PKP failure was irreversible rejection (7%, n = 114). Independent risk factors identified for decreased PKP survival were: 1 or more episodes of reversible rejection, active inflammation at PKP, preexisting corneal vascularization, intraoperative complications, small graft size (≤ 7.25 mm), large graft size (≥ 8.5 mm), preoperative glaucoma, and a preoperative diagnosis of regraft or trauma. A best-corrected Snellen visual acuity of 6/12 or better was achieved in 60% of eyes [mean: 6/15 (logarithm of the minimum angle of resolution 0.40)]. Keratoconus and Fuchs endothelial dystrophy were the diagnoses with best survival and visual outcome, whereas, bullous keratopathy, trauma or noninfective keratitis were associated with poorer visual outcome.
  
  
  CONCLUSIONS
  Several independent risk factors were identified that significantly influenced PKP first year survival outcome. This information is valuable to patients and surgeons with respect to determining prognosis and clinical decision making.
authors.affiliation: Department of Ophthalmology and the New Zealand National Eye Bank, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, 1023 New Zealand.
authors.forename: Hussain Y
authors.initials: HY
authors.lastname: Patel
authors.forename: Sue
authors.initials: S
authors.lastname: Ormonde
authors.forename: Nigel H
authors.initials: NH
authors.lastname: Brookes
authors.forename: S Louise
authors.initials: SL
authors.lastname: Moffatt
authors.forename: Trevor
authors.initials: T
authors.lastname: Sherwin
authors.forename: David G C
authors.initials: DG
authors.lastname: Pendergrast
authors.forename: Charles N J
authors.initials: CN
authors.lastname: McGhee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea; D003316:Corneal Diseases / Q000601:surgery*; D016208:Databases, Factual; D005125:Eye Banks / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D009926:Organ Preservation; D011446:Prospective Studies; D012307:Risk Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult