[Prognosis of keratoplasty in keratitis scrophulosa peracta].

BACKGROUND

In spite of clear transplants the results of keratoplasty are often disappointing. We looked for possible reasons for these failures.

PATIENTS AND

METHODS

We analyzed in 204 eyes of 115 patients the factors influencing the prognosis. Our results are based on medical records and on demanded reports of the treating ophthalmologists. Patients were divided after different aspects (method of operation, beginning of the disease, operation of the first or second eye).

RESULTS

A frequently associated cataract and the method of surgery (aphakia, one- or two-step, triple procedure) has no influence on the prognosis. However, age of onset and density of corneal scars are crucial. This is especially evident in eyes first operated on. In case of early onset (before the age of five) visual acuity only reached 0.21 average postoperatively, whereas patients with late onset gained visual acuity of 0.59. The fellow eye (n = 89) had postoperative visual acuity of 0.48. In patients with poor postoperative visual improvement (< or = two lines) high myopia was apparent in 50%.

CONCLUSION

For estimating the prognosis besides early childhood amblyopia we must take into account high myopia induced by formdeprivation (FDM). Exact evaluation of patients' history and preoperative ultrasound biometry are recommended.