Ten-year follow-up of graft survival and visual outcome after penetrating keratoplasty in Sweden.

PURPOSE: To determine factors influencing graft survival and visual outcome 10 years after penetrating keratoplasty.

METHODS

Ten-year follow-up data were obtained from a cohort of patients that represented 20% of corneal transplants in Sweden between 1996 and 1998. Multiple regression analyses (logistic and linear) were performed on graft survival and visual outcome (visual acuity and astigmatism).

RESULTS

Of the initial 242 patients receiving a corneal transplant during 1996-1998, 140 were available at 10 years. The majority of patients lost to follow-up had the indication bullous keratopathy and many were deceased. Overall, 71% of transplants available for follow-up at 10 years were still functioning, with keratoconus showing the best result (88%) and bullous keratopathy the worst (48%). Complications during the first 2 postoperative years reduced the percentage of functioning grafts at 10 years from 84% to 50%. The visual acuity was influenced by indication and postoperative complications. The change in Snellen lines between preoperative and 10-year visual acuity for the individual patients also depended on indication and postoperative complications. Most of the changes occurred during the first 2 postoperative years. The astigmatism at 10 years was also affected by postoperative complications and in addition by the amount of astigmatism at 2 years.

CONCLUSION

Graft survival and visual outcome at 10 years depended on indication and postoperative complications. Most improvement of vision occurred during the first 2 years and was predictive of the 10-year visual outcome.