Outcomes of penetrating keratoplasty for macular corneal dystrophy.
OBJECTIVE
To report the outcomes of penetrating keratoplasty (PKP) in patients with macular corneal dystrophy (MCD).


METHODS
This retrospective case series includes consecutive patients with MCD who underwent PKP from 1986 to 2006 with at least 6 months' follow-up. Main outcome measures included best spectacle-corrected visual acuity (BSCVA), postoperative astigmatism and graft survival.


RESULTS
Sixty-two eyes of 39 patients with mean age of 34.0±10.5 (range 13-58) years at the time of keratoplasty were included for analysis. After a mean follow-up period of 52.0±47.3 (range 6-190) months, BSCVA improved from 1.4±0.4 logMAR (4/100) preoperatively to 0.2±0.3 logMAR (20/32) at final follow-up (P<0.001).Mean postoperative BSCVA was 0.15±0.40 logMAR in patients (36 eyes) aged less than 35 years at the time of surgery as compared to 0.26±0.25 logMAR in subjects (26 eyes) older than 35 years (P=0.005). Final astigmatism was comparable with different suturing techniques including separate, continuous, and combined sutures (P=0.9). All grafts were clear at final follow-up except a single case of MCD with visually insignificant recurrence.Episodes of immunologic graft rejection occurred in 12 eyes (19.4%) but none led to graft failure.


CONCLUSIONS
PKP for MCD entails favorable outcomes in terms of graft survival and visual improvement. Final visual acuity seems to be better when transplantation is performed before the age of 35 years.
Labbafinejad Medical Center, Shahid Beheshti University, MC, Tehran, Iran.
Farid
F
Karimian
Ali-Reza
AR
Baradaran-Rafii
Sepehr
S
Feizi
Mohammad
M
Zare
Mohammad-Reza
MR
Jafarinasab
Mohammad-Ali
MA
Javadi
S Ali
SA
Mirdehghan
Bahram
B
Einollahi