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Lee and Kim: Long-Term Outcomes of Penetrating Keratoplasty in Treating Macular Corneal Dystrophy, TGFBI Dystrophy, and Fuchs' Dystrophy
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(10): 1397-1402.

Published online: 17 October 2012

DOI: https://doi.org/10.3341/jkos.2012.53.10.1397

Long-Term Outcomes of Penetrating Keratoplasty in Treating Macular Corneal Dystrophy, TGFBI Dystrophy, and Fuchs' Dystrophy

You Kyung Lee, MD, Man Soo Kim, MD, PhD

Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea.

Address reprint requests to Man Soo Kim, MD, PhD. Department of Ophthalmology, The Catholic University of Korea, Seoul St. Mary's Hospital, #222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea. Tel: 82-2-2258-6197, Fax: 82-2-599-7405, mskim@catholic.ac.kr

Received 16 March 2012       Accepted 12 August 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To compare long-term outcomes of penetrating keratoplasty in treating macular corneal dystrophy, transforming growth factor beta induced (TGFBI) dystrophy, and Fuchs' dystrophy.

Methods

The present retrospective study describes the postoperative results of 123 eyes in 70 patients; 53 eyes with macular corneal dystrophy, 20 eyes with TGFBI dystrophy, and 50 eyes with Fuchs' dystrophy. All patients received penetrating keratoplasty. The outcome measures included recurrence rate, graft rejection, graft survival rate and corneal endothelial density and other complications.

Results

As compared with the other groups, TGFBI dystrophy had the highest recurrence rate (p-value < 0.0001). Fuchs' dystrophy had the lowest graft survival rate (p-value = 0.03). Corneal endothelial cell density was lowest in Fuchs' dystrophy 10 years postoperatively (p-value = 0.0006), but there was no significant difference in corneal endothelial cell density between the 3 groups 1 and 5 years postoperatively. There was no significant difference between the 3 groups in other complications such as graft rejection, secondary glaucoma and persistent epithelial defect (p-value = 0.809, p-value = 0.584, p-value = 0.972, respectively).

Conclusions

Penetrating keratoplasty showed different long-term outcomes in treating 3 types of corneal dystrophies. The difficulty may depend on the pathogenesis of corneal dystrophies.

Keywords: Fuchs' dystrophy, Macular dystrophy, Penetrating keratoplasty, Transforming growth factor beta induced (TGFBI) dystrophy

Figures and Tables

Figure 1
Kaplan-Meier graph showing overall recurrence-free survival rate of penetrating keratoplasty in treating three corneal dystrophy groups. As compared with the other groups, TGFBI corneal dystrophy group had the highest recurrence rate (p-value < 0.0001).
jkos-53-1397-g001
Figure 2
Kaplan-Meier graph showing overall graft survival rate of penetrating keratoplasty in treating three corneal dystrophy groups. Fuchs' dystrophy had the lowest graft survival rate (p-value = 0.03).
jkos-53-1397-g002
Figure 3
Bar graph showing changes of corneal endothelial cell density of penetrating keratoplasty in treating three corneal dystrophy groups. Corneal endothelial cell density was lowest in Fuchs' dystrophy 10 years postoperatively (*p-value = 0.032), but there was no significant difference in corneal endothelial cell density between the 3 groups 1 and 5 years postoperatively.
jkos-53-1397-g003
Table 1
General characteristics of the patients undergoing penetrating keratoplasty due to corneal dystrophy
jkos-53-1397-i001

Values are presents as mean ± SD or number unless otherwise indicated.

*Transforming growth factor beta induced; †Statistical significance was tested by one way ANOVA; ‡Statistical significance was tested by Chi square test; §Statistically significant.

Table 2
Complications of penetrating keratoplasty in treating three corneal dystrophy groups
jkos-53-1397-i002

*Transforming growth factor beta induced; †Statistical significance was tested by Chi square test.

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