[Long-term outcome after penetrating keratoplasty for bullous keratopathy - influence of preoperative visual acuity on final outcome].

Abstract

PURPOSE:

The aim of this study was to analyse the long-term functional results of penetrating keratoplasty for pseudophacic bullous keratopathy and Fuchs endothelial dystrophy and to analyse the potential influence of the preoperative visual acuity on the final outcome.

PATIENTS AND METHODS:

This retrospective study describes the postoperative results of 413 patients. 154 of them with bullous keratopathy and 259 patients with Fuchs dystrophy. All received penetrating excimer laser keratoplasty (PK).The results include the examination of the patients 1 / 3 / 5 / 8 / > 9 years postoperatively. For analysis the patients were divided in two groups: group I includes patients with a visual acuity ≤ 0.1 and group II with a visual acuity > 0.1. The trephination was performed using a 193 nm excimer laser. The transplanted cornea was fixed by using a double running cross-stitch suture. The outcome measures included best corrected visual acuity (CCV), keratometric equivalent (KEQ), keratometric astigmatism (AST), spherical equivalent (SEQ), refractive cylinder (CYL), best corrected visual acuity (BCVA), surface regularity index (SRI), surface asymmetry index (SAI), potential visual acuity (PVA), pachymetry (PAC), endothelial cell count (ECC), intraocular tension (TEN), topographic equivalent (T-EQ) and topographic astigmatism (T-AST).

RESULTS:

5 / 8 years postoperatively CCV was 0.55 / 0.58; KEQ was 43.75 / 45.64 D; SEQ - 0.88 /- 1.88 D; AST was 3.91 / 4.41 D; CYL was 3.09 / 3.40 D; ECC was 1230 / 1080 cells/mm (2); TEN was 13.61 / 14.36 mmHg; PAC was 593.21 / 579.50 µm; SRI was 1.08 / 0.89; SAI was 1.31 / 1.10; PVA was 0.77 / 0.83; T-EQ was 44.78 / 44.92 D and T-AST was 4.85 / 3.92 D. The outcome of patients with a preoperative visual acuity of ≤ 0.1 was significantly worse than the group with the visual acuity of > 0.1.

CONCLUSION:

This study shows that the long-term results after penetrating keratoplasty for pseudophacic bullous keratopathy and Fuchs endothelial dystrophy are good. Patients with preoperative visual acuity of ≤ 0.1 had worse final results.

• Authors: A Reimer, A Langenbucher, C Cursiefen
• Journal: Klinische Monatsblatter fur Augenheilkunde (Klin Monbl Augenheilkd) Vol. 229 Issue 2 Pg. 149-57 (Feb 2012) ISSN: 1439-3999 [Electronic] Germany
• Vernacular Title: Langzeitergebnisse nach perforierender Keratoplastik bei bullöser Keratopathie - Auswirkungen von präoperativem Visus auf die Ergebnisse.
• PMID: 22095151 (Publication Type: Comparative Study, English Abstract, Journal Article)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Astigmatism (diagnosis, physiopathology)
• Child
• Child, Preschool
• Corneal Opacity (physiopathology, surgery)
• Corneal Topography
• Endothelium, Corneal (physiopathology)
• Female
• Follow-Up Studies
• Fuchs' Endothelial Dystrophy (physiopathology, surgery)
• Humans
• Keratoplasty, Penetrating
• Male
• Middle Aged
• Postoperative Complications (diagnosis, physiopathology)
• Preoperative Care
• Pseudophakia (physiopathology, surgery)
• Retrospective Studies
• Treatment Outcome
• Visual Acuity (physiology)
• Young Adult