RESULTS OF PENETRATING KERATOPLASTY IN TERTIARY CARE CENTRE

  • Dr Ravi Chauhan Indira Gandhi Govt. Medical College, Nagpur, India
  • Dr N. G. Raut Indira Gandhi Govt. Medical College, Nagpur, India
  • Dr S. S. Pendke Indira Gandhi Govt. Medical College, Nagpur, India
  • Dr Sandesh Sonarkhan Indira Gandhi Govt. Medical College, Nagpur, India
  • Dr Satish Solanke Indira Gandhi Govt. Medical College, Nagpur, India
  • Dr Anup Mondal Indira Gandhi Govt. Medical College, Nagpur, India
Keywords: Visual outcome, penetrating keratoplasty, Graft Failure

Abstract

Blindness due to corneal scarring is one of the leading causes of treatable blindness. Full thickness penetrating keratoplasty is still considered to be the most acceptable surgical method, keeping this in mind and with the Purpose To study visual outcome after penetrating keratoplasty and to evaluate intra and post operative complications and to study the various factors which influences the graft survival. In our study we have operated 32 eyes of 32 patients and they were studied over 24 month’s period. Patient with all types of corneal opacity, Keratoconus and Failed corneal transplant were considered for optical keratoplasty. At the end of 24 months we found that Out of 32 patient’s male to female ratio was 2.2:1.Mean age was 47 ±12 years. Most common indication was corneal scar (43.75) most common preoperative risk factor for graft failure was vascularised recipient cornea (28.12%). Good quality graft (2+) had better survival rate (83.33%) and better visual prognosis (81.8%).Small graft size had better survival rate (78.57%) Young donor below 50 years of age, graft survival rate was 87%.Most common intraoperative complication was suture related difficulties (28.12%). Postoperative corneal graft edema was commonest complication (57%) Total 34.36% of patients gained vision ≥ 6/24. 37.5% patients between 4/60-6/60. Total graft survival rate was 71.87%.Total corneal graft failure rate was 28.13%.Conclusions: Full thickness Penetrating Keratoplasty gives satisfactory visual outcome .Pre-operative evaluation of donor corneas & recipient eyes is important. Post operative follow up is recommended.

Downloads

Download data is not yet available.

References

1. Foster A. Vision 2020Fthe right to sight (editorial). Trop Doct 2003; 33: 193–194.
2. Thylefors B, Negrel AD, Pararajasegaram R, Dadzie KY. Global data on blindness. Bull WHO 1995; 73: 115–121.
3. Congdon NG, Friedman DS, Lietman T. Important causes of visual impairment in the world today. JAMA 2003; 290: 2057–2060.
4. Dandona L, Dandona R, Srinivas M, Giridhar P, Vials K, Prasad MN et al. Blindness in the Indian state of Andhra Pradesh. Invest Ophthalmol Vis Sci 2001; 42: 908–916.
5. Birk DE, Trelstad RL. Extracellular compartments in matrix morphogenesis: collagen fibril, bundle, and lamellar formation by corneal fibroblasts. J Cell Biol 1984; 99:2024-2033.
6. Jay H. Krachmer, Mark J. Mannis, and Edward J. Holland. Cornea 3rd edition.
7. Dua HS, Faraj LA, Said DG, Gray T, Lowe J (2013 Sep). "Human corneal anatomy redefined: a novel preDescemet's layer (Dua's layer)". Ophthalmology 120 (9): 1778–85..
8. Kurana AK.Cornea, limbus, sclera in Anatomy and physiology of eye.2nd edition 2006;21-42.
9. Henry F. Edelhauser. The Balance between Corneal Transparency and Edema. The Proctor Lecture IOVS, May 2006, Vol. 47, No. 5 :1759.
10. Namrata S,Chandra Shakher,Rasik B Vajpayee.evolution of corneal Grafting surgery in Corneal Transplantation.2nd edition 2010;1-3.
11. Anwar M, Teichmann KD. Bigbubble technique to bare Descemet’s membrane in anterior lamellar keratoplasty.J Cataract Refract Surg 2002;28(3):398-403
12. Mellea GR, Lander F, Rietveld F J, Beekhis W H, Binder P S. Anew surgical technique for deep stromal, anterior lamellar Keratoplasty.Br J Ohntalmolo 1999;83(3):327-33.
13. Filtaov VP, Tranplantation of cornea.Arch Ohthalmol1935;13321-47.
14. Filtaov VP, Bajenova MA. Cultured og drird corneal tissue.Arch Ohthalmol and Rev Gen ophthalmol1937;1;385.
15. HymanL, WittpenJ,Yang C. Indications and techniques of penetrating keratoplsty 1985-1988. Cornea1992; 11:573.
16. Patel NP, Kim T, Rapuano CJ,Cohen EJ, Labison PR. Indications for penetrating keratoplasty 1989-1995 ophthalmology 2000;107:719-24.
17. Urmila Ghatak,Rajesh Sinha,Rasik B Vajpayee.indication and outcome of penetrating keratoplasty in Corneal Transplantation.2nd edition 2010;4-12.
18. Geoffrey C,Tabin,Rita Gurung, Govinda Paudyal.Penetrating keratoplasty in Nepal cornea. Volume 23 (6): Aug 2004:589-596.
19. Shilpa A Joshi, Seema S Jagdale, Pranav D More, and Madan Deshpande outcome of optical penetrating keratoplasty at a tertiary care eye institute in western
India.Indian J Ophthalmol. 2012 JanFeb; 60(1): 15–21.
20. AK bansal, GN rao penetrating keratoplasty in LC Dutta modern ophthalmology volume 1,2013; 257.
21. keates RH, Falkensein S, keratoplasty in keratoconus . Am J Ophthalmol 1972;74:442-44.
22. Kirkness CM, Ficker LA, Steele AD, Rice NS. The success of keratoplasty i for keratoconus. Eye 1990;86:807-11.
23. Pineros O, Cohen EJ, Rspauno CJ, Laibson PR, Long term result after penetrating keratoplasty for Fuch’s endothelial dystrophy. Arch Ophthalmol 1996; 14:15-18
24. Olson RJ, Mattingly TP, Waltman SR, Kuafman HE, Aphkakic keratoplasty : visual acuity and optic errors.Ophthalmology 1880;87:680-86.
25. Stulting RD, Sumers KD, Cavanag HD,Waring GO 3rd, Gammon JA. Penetrating keratoplasty in children. Ophthalmology 1984;91:1222-30
26. Dana M R, Moyes A L, Gomez J A, Rosheim K M, Scumberg D A, Laibson P R, Holland E J, Suger A, Suger J. indication for and outcome in pediatric keratoplasty. A multicenter study. Ophthalmology 1995; 102:1129-38.
27. Vail A, Gore SM, Bradley BA, Easty DL, Rogers CA. Corneal graft survival and visual outcome. A multicenter Study. Corneal Transplant Follow-up Study Collaborators. Ophthalmology. 1994 Jan;101(1):120–127.
28. Rao GN, Shaw EL, Aurther EJ. Endothelial cell morphology and corneal deturescence. Ann ophthalmology 1979; 11;885.
29. Ben Connell, Michael S Loughnan,Rasik B Vajpayee.Corneal graft rejection in Corneal Transplantation.2nd edition 2010;122-127.
30. William KA Et al: Factors Predictive Of Corneal Graft Survival; Ophthalmology 1992; 99; 403-14.
31. Mohan M, Panda A, Kumar TS Results of penetrating keratoplasty in vascularized corneas. Ann Ophthalmol. 1990 Jun;22(6):235-8.
32. Williams KA, Roder D, Esterman A, Muehlberg SM, Coster DJ Factors predictive of corneal graft survival. Report from the Australian Corneal Graft Registry.Ophthalmology 1992, 99(3):403-414.
33. Cobo LM, Coster DJ, Rice NS, Jones BRPrognosis and management of corneal transplantation for herpetic keratitis. Arch Ophthalmol. 1980 Oct;98(10):1755-9.
How to Cite
1.
Dr Ravi Chauhan, Dr N. G. Raut, Dr S. S. Pendke, Dr Sandesh Sonarkhan, Dr Satish Solanke, Dr Anup Mondal. RESULTS OF PENETRATING KERATOPLASTY IN TERTIARY CARE CENTRE. Med. res. chronicles [Internet]. 2020Jul.28 [cited 2024Dec.22];3(1):82-0. Available from: https://medrech.com/index.php/medrech/article/view/161
Section
Original Research Article