THE RESULTS OF PENETRATING KERATOPLASTY FOR KERATOCONUS
Abstract
Background. To evaluate etiology, indications, results and complication rates associated with corneal transplantation for keratoconus.
Methods. In this retrospective clinical study, 101 eyes of 79 patients had corneal transplantation. Mean age at surgery was 30.5 years. Follow up period was 2 to 25 yrs. All surgeries were performed by one surgeon. Candidate for surgery were patients who cannot tolerate contact lenses or are not adequately visually rehabilitated by them. Before surgery the best corrected visual acuity was 0.05 to 0.3 in 27%; 73% of patients had uncorrected visual acuity hand movement or counting fingers.
Results. Best corrected visual acuity postoperatively was in 72% of patients 0.5 to 1.0and in 26% 0.4 to 0.1. 2% of patients had visual acuity less than 0.1. In all cases we had postkeratoplasty astigmatism of 2.5 ± 4.75Cyl with or without residual myopia. The most often postoperative complication was graft rejection (10%) which was successfully treated with medications. Unsuccessfull rate was 3%.
Conclusions. The improved results, low complication rate, and postoperative enhancement management indicate that corneal transplantation is a viable option in the clinical course of keratoconus. The optimal visual acuity postoperatively is achieved with contact lens, which correct postoperative astigmatism and myopia. Improvements in refractive surgery can help manage with postkeratoplasty astigmatism and myopia.
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