Aurija Kalasauskienė, Eglė Drebickaitė, Gabrielė Legotaitė

Abstract

Keratoconus is the most common reason for keratoplasty in the world. The disease affects young, working-age people, so in late stage, when other treatment methods are ineffective, the keratoplasty can return sight. Objective. To evaluate the early postoperative outcomes after penetrating keratoplasty – visual acuity change, relevant post-operative events, complications, associated with corneal transplantation for keratoconus. Materials and methods. This was a retrospective study in the Lithuanian University of Health Sciences of Medicine Eye Department during 2001–2014 years. We analyzed patients’ medical histories after corneal keratoplasty. Statistical analysis was performed using SPSS (23 edition) computer program. Results. The penetrating keratoplasty for keratoconus was performed in 71 (24,83 %) eye in 2001-2014 years. 59 recipients transplant donor cornea in one eye, 6 in both eyes. Transplantation distribution of the affected eye is not statistically significant (p>0,635): the right eye keratoplasty – 33 patients (46,5 %), left – 38 patients (53,5%). By gender research were distributed as follows: 19 (26,8%) women with a median age 39 (27-46) years and 52 (73,2%) men, with a median age 28,5 (25-36) years. Keratoplasty operation for men was performed about 10,5 years younger than for women (p<0,001). It was found that after a corneal transplantation, 95,8% recipients visual acuity improved: slightly – to 32,4 %., on average – 50,7%, significantly – by 12,7 %. Only 4,2 % recipients visual acuity remained the same or even worse. Cataract and glaucoma were not statistically significant diseases of visual acuity change (p> 0.05). In older age the visual acuity is less (r = -0,234, p=0,039). Smooth postoperative stroke (recorded without complications) were 40 (56,3 %) recipients. 31 subjects (43,7%) observed various complications. The overall complication rate was 58: 21 recipient had one of the complications, the remaining – two or more. Corneal rejection reaction – 14 (24,1%) recipients, corneal edema – 13 (22,5 %) recipients, seam (-s) relaxation – 12 (20,7 %) recipients, increased intraocular pressure – 8 (13,8 %) recipients, graft vascularisation – 5 (8,6 %) recipients, Descemet’s membrane was folds – 4 (6,9 %) recipients, infiltration of the joints – 2 (3,4 %) recipients. Conclusions. In the Lithuanian University of Health Sciences of Medicine Eye clinic during 2001-2014 years the quarter (24,8%) of penetrating keratoplasty reasons accounted for keratoconus. The penetrating keratoplasty on right and left eyes were performed equally (46,5 proc. v.s. 53,5 proc., p>0,635). Corneal transplantation for men was performed more frequently (73,2proc. vs. 26,8proc., p<0,001) and about 10,5 years younger than for women (p<0,019). After keratoplasty 95,8 % cases visual acuity improved and only 4,2% recipients visual acuity remained the same or even worse. Cataract and glaucoma were not statistically significant diseases of visual acuity change (p>0,05). In older age the visual acuity is less. 40 (56,3 proc.) recipients have no post-operative complications. The most common complication after keratoplasty surgery for keratoconus were corneal rejection reaction (24,1 proc.), but neither one patient did not need corneal retransplantation.

Keyword(s): keratoconus; visual acuity; postoperative course.
DOI: 10.5200/sm-hs.2016.053
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