title: Penetrating keratoplasty versus lamellar keratoplasty for mustard gas-induced keratitis.
abstract: OBJECTIVE
  To compare the outcomes of penetrating keratoplasty (PK) and lamellar keratoplasty (LK) in patients with mustard gas keratitis.
  
  
  METHODS
  A total of 78 eyes of 55 patients with mustard gas keratitis were included. Of these eyes, 27 (34.6%) underwent PK and 51 (63.4%) received LK. Keratolimbal allografts were performed in 11 and 30 eyes of the PK and LK groups, respectively. The study groups were compared in terms of best spectacle-corrected visual acuity, refractive error, and keratometry readings. The Kaplan-Meier survival curve and log-rank test were used to evaluate and compare the cumulative incidence of rejection-free graft survival and graft survival in PK and LK.
  
  
  RESULTS
  At the time of keratoplasty, the mean patient ages were 40.3 ± 4.5 years and 43.4 ± 8.3 years in the PK and LK groups, respectively (P = 0.08). The patients were followed-up for 53.2 ± 27.5 and 40.4 ± 29.6 months, respectively (P = 0.09). At the last follow-up, the 2 study groups were comparable with respect to best spectacle-corrected visual acuity (P = 0.87), refraction (P = 0.08), and keratometric astigmatism (P = 0.27). At the 33-month follow-up examination, the rejection-free graft survival rates were 33.6% in the PK group and 90% in the LK group, with mean durations of 34.6 and 84.8 months, respectively (P < 0.001). Moreover, the graft survival rates were 77.3% and 91.7%, with mean durations of 67.5 and 76.1 months, respectively (P = 0.03). Three eyes that had received LK underwent PK because of significant interface haziness.
  
  
  CONCLUSIONS
  LK is preferred to PK in the majority of mustard gas victims. However, PK should always be performed in certain conditions.
authors.affiliation: Ophthalmic Research Center, Ophthalmology Department, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sepehr
authors.initials: S
authors.lastname: Feizi
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Javadi
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Jafarinasab
authors.forename: Farid
authors.initials: F
authors.lastname: Karimian
mesh_terms: D000328:Adult; D002619:Chemical Warfare Agents / Q000633:toxicity*; D016039:Corneal Transplantation / Q000379:methods*; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D007634:Keratitis / Q000139:chemically induced / Q000503:physiopathology / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D009151:Mustard Gas / Q000633:toxicity*; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology
chemical_list: D002619:Chemical Warfare Agents; D009151:Mustard Gas