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Lee, Hwang, Hwang, and Kim: Long Term Clinical Results of Penetrating Keratoplasty for Macular Corneal Dystrophy
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(10): 1425-1431.

Published online: 17 October 2012

DOI: https://doi.org/10.3341/jkos.2012.53.10.1425

Long Term Clinical Results of Penetrating Keratoplasty for Macular Corneal Dystrophy

Ji Myung Lee, MD, Kyu Yeon Hwang, MD, Ho Sik Hwang, MD, MS, Man Soo Kim, MD, PhD

Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, 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: 82-2-2258-1188, Fax: 82-2-2258-1173, mskim@catholic.ac.kr

Received 30 March 2012       Accepted 10 September 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report the long term clinical results of penetrating keratoplasty as a treatment for corneal macular dystrophy.

Methods

Retrospective review of the medical record of 46 eyes (31 indivisuals) who underwent primary PK for corneal macular dystrophy at the Seoul St. Mary's Hospital between November, 1986 and December, 2011. Data extracted preoperative and postoperative best-corrected visual acuity (BCVA), postoperative complications (including graft rejection episodes, and recurrent dystrophy), change of endothelial cell density at 1, 6, 12, 24, 36 months and yearly thereafter.

Results

After a mean follow-up period of 91.59 ± 3.2 months, the mean BCVA was significantly improved after penetrating keratoplasty. Endothelial cell loss rate was marked during the 1st year after penetrating keratoplasty. Graft survival was 40 graft (89.7%) at 8yrs. There was a statistically significant increased likelihood of graft failure if the patient was older than 40 years at the time of surgery (p = 0.03). Glaucoma as postoperative complication was 17.4%. Clinically significant recurrence was 2%.

Conclusions

Penetrating keratoplasty is associated with a good visual outcome and prognosis for graft survival of long-term efficacy with a low complication rate in eyes with macular corneal dystrophy.

Keywords: Corneal macular dystrophy, Penetrating keratoplasty

Figures and Tables

Figure 1
Change of data during post-operative follow Up. (A) The mean BCVA was significantly improved after penetrating keratoplasty. Mean BCVA was 0.78 ± 0.21 for 1 month, 0.46 ± 0.15 for 6 month, 0.38 ± 0.12 for 12 month, 0.36 ± 0.17 for 24 month, 0.35 ± 0.17 for 48 month (log MAR) (B) Rate of endothelial cell loss based on preoperative donor endothelial cell density. Post-operative endothelial cell loss rate was 33.43 ± 21.65% for 12 month, 44.44 ± 18.94% for 24 month, 56.79 ± 19.42% for 36 month. (C) There was change of corneal thickness during each period: 597 ± 42.9 for 1 month, 592 ± 35.6 for 6 month, 543 ± 39.2 for 12 month, 522 ± 13.4 for 24 month, 559.1 ± 27.6 for 48 month, 536 ± 18.9 for 60 month (µm). (D) There was change of graft survival rate during each period. The survival rate was 98.2% for 1yr, 97.3% for 2 yr, 94.6% for 4 yr, 92.1% for 6 yr, 89.7% for 8 yr. BCVA = best-corrected visual acuity.
jkos-53-1425-g001
Table 1
Preoperative characteristics of participants
jkos-53-1425-i001

Values are presented as mean ± SD or number.

BCVA = best corrected visual acuity; SD = standard deviation.

Table 2
Graft survival versus recipient age at the time of penetrating keratoplasty
jkos-53-1425-i002

Values are presented as mean ± SD or number (%) unless otherwise indicated.

AxL = axial length; NV = neovascularization; SD = standard deviation.

*Significant differences in graft failure between older than 40 and younger.

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