title: Indications and Visual Outcome of Penetrating Keratoplasty in Tertiary Eye Care Institute in Uttarakhand.
abstract: BACKGROUND
  Corneal blindness forms significant proportion of visual blindness in developing countries and penetrating keratoplasty (PK) can restore vision for this. The prognosis of PK is dependent on the corneal diseases responsible for corneal blindness.
  
  
  OBJECTIVE
  To evaluate the indications and visual outcome of PK in tertiary eye care institute in Uttarakhand.
  
  
  METHODS
  Data was reviewed from the medical records of 145 PK done in Department of Ophthalmology, Himalayan Institute of Medical Sciences from January 2012 to October 2014. Analysis of data was done for evaluation of the indications and visual outcome by Paired student's t-test for hypothesis testing of grouped values of preoperative and last follow-up best corrected visual acuity in cases of optical and therapeutic grafts. A p-value < 0.05 was considered statistically significant.
  
  
  RESULTS
  In this study data of 145 eyes of 138 patients was reviewed. The most common indication for keratoplasty was corneal scarring including adherent leucoma 48 (33.10%). Therapeutic keratoplasty was done for 33 cases with maximum 30(20.68%) cases of infectious keratitis. One case of tectonic graft was included in therapeutic keratoplasty group for analysis. There was statistically significant difference (p=.0001) in best corrected visual acuity improvement from 1.39 logMAR+ 0.022(SD) preoperatively to 0.367 logMAR+0.44(SD) postoperatively and 1.4 logMAR+.000(SD) preoperatively to 0.16 logMAR+0.57(SD) postoperatively for optical and therapeutic grafts respectively.
  
  
  CONCLUSIONS
  Infective keratitis either active or healed was the major indication for keratoplasty. Poor prognosis indications were most common in this part of the country. The visual outcome following corneal transplantation was encouraging particularly in cases of optical keratoplasty.
authors: Assistant Professor, Department of Ophthalmology, HIMS, Swami Rama Himalayan University , Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India .
authors: Anuradha
authors: A
authors: Raj
authors: Assistant Professor, Department of Ophthalmology, HIMS, Swami Rama Himalayan University , Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India .
authors: Neeti
authors: N
authors: Gupta
authors: Professor, Department of Ophthalmology, HIMS, Swami Rama Himalayan University , Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India .
authors: Renu
authors: R
authors: Dhasmana
authors: Professor, Department of Ophthalmology, HIMS, Swami Rama Himalayan University , Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India .
authors: Ramesh Chander
authors: RC
authors: Nagpal
authors: Professor, Department of Ophthalmology, HIMS, Swami Rama Himalayan University , Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India .
authors: Harsh
authors: H
authors: Bahadur
authors: Associate Professor, Department of Ophthalmology, HIMS, Swami Rama Himalayan University , Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand, India .
authors: Amit
authors: A
authors: Maitreya
keywords: Corneal blindness; Developing country; Optical penetrating keratoplasty; Therapeutic penetrating keratoplasty