Wagoner M.D., Ba-Abbad R., Al-Mohaimeed M., Al-Swailem S., Zimmerman M.B.
Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52246, United States; Department of Ophthalmology, Faculty of Health Sciences, University of Stellenbosch, South Africa; Department of Biostatistics, University of Iowa Carver College of Medicine, Iowa City, IA, United States
Wagoner, M.D., Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52246, United States, Department of Ophthalmology, Faculty of Health Sciences, University of Stellenbosch, South Africa; Ba-Abbad, R., Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Al-Mohaimeed, M., Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Al-Swailem, S., Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Zimmerman, M.B., Department of Biostatistics, University of Iowa Carver College of Medicine, Iowa City, IA, United States
PURPOSE: To evaluate the prevalence of postoperative complications and their impact on graft survival after primary adult optical penetrating keratoplasty (PKP). METHODS: A retrospective review was done of consecutive cases of PKP performed between January 1, 1997, and December 31, 2001, for keratoconus, corneal edema, stromal scarring, and stromal dystrophy. RESULTS: The inclusion criteria were met by 910 eyes, including 464 with keratoconus, 188 with corneal edema, 175 with stromal scarring, and 83 with stromal dystrophy. One or more complications occurred in 362 eyes (39.8%). The most common complication was endothelial rejection (17.3%), followed by glaucoma worsening (15.5%), bacterial keratitis (5.8%), persistent epithelial defects (3.4%), and wound dehiscence (1.6%). There were significant differences among the surgical groups in overall prevalence of complications (P < 0.001) and with the prevalence of endothelial rejection (P = 0.01), glaucoma worsening (P < 0.001), bacterial keratitis (P = 0.04), and persistent epithelial defects (P = 0.02). Complication-associated graft failure varied significantly among the surgical groups (P = 0.02). CONCLUSION: The prevalence of post-PKP complications and their impact on graft survival vary significantly among surgical indications for primary adult optical PKP. © 2009 by Lippincott Williams & Wilkins.
prednisolone acetate; adolescent; adult; aged; article; child; cornea disease; cornea dystrophy; cornea edema; drug dose reduction; endophthalmitis; glaucoma; graft failure; graft rejection; graft survival; human; keratitis; keratoconus; major clinical study; penetrating keratoplasty; postoperative complication; prevalence; priority journal; school child; stromal scarring; wound dehiscence; Adolescent; Adult; Aged; Aged, 80 and over; Child; Cornea; Corneal Diseases; Female; Follow-Up Studies; Graft Survival; Humans; Keratoplasty, Penetrating; Male; Middle Aged; Postoperative Complications; Prevalence; Retrospective Studies; Young Adult