A 10-year review of penetrating keratoplasty.

PURPOSE: To survey the changes in indications for penetrating keratoplasty (PKP) and re-evaluate the risk factors for allograft rejection and graft failure.

METHODS

We evaluated the records of 396 eyes of 335 patients who had undergone PKP at the Tokyo University Hospital between 1987 and 1997. Clinical results were analyzed by the Kaplan-Meier life table method and the log-rank test.

RESULTS

The overall rates of graft survival and rejection-free graft survival at 10 years were 72.2% and 76.8%, respectively. The rates of graft survival and rejection-free graft survival were 98.8% and 86.6% in keratoconus, 87.0% and 56.5% in herpetic keratitis, 76.9% and 73.1% in corneal dystrophy and degeneration, 69.4% and 80.6% in nonherpetic keratitis, 62.5% and 75.0% in chemical burns, 61.8% and 72.1% in regrafting, and 51.1% and 79.8% in bullous keratopathy, respectively. The graft survival rates were statistically higher in the PKP alone group than in the combined operation group. The graft survival and rejection-free graft survival rates were statistically higher in the first operation group than in the regrafted group, and in the avascular cornea group than in the vascular cornea group.

CONCLUSIONS

We recognized changes in indications for PKP. Combined operation, reoperation, and vascularization of recipient cornea were risk factors for graft failure.