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Twelve-year follow-up of penetrating keratoplasty

  • Clinical Investigation
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Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the long-term outcomes of penetrating keratoplasty (PKP) according to the corneal disease diagnosis and the number of PKP procedures performed.

Methods

Five-hundred-and-nine eyes from 403 patients who underwent PKP at Miyata Eye Hospital in Japan from 1998 through 2014, were included in this study. Medical charts were retrospectively examined to ascertain the corneal disease diagnosis and the period of graft survival. Graft survival rates were compared among various corneal disease diagnoses and among the number of PKP procedures performed. Changes in corneal endothelial cell density (ECD) were analyzed using a mixed-effects model. The presence/absence of various risk factors was compared between transparent grafts and failed grafts.

Results

The overall rate of graft survival at 12 years was 60.4%. The rates of graft survival in keratoconus was 100%, in corneal dystrophy 100%, in leukoma 70.8%, and in bullous keratopathy 51.7%. The rates of graft survival at 12 years for the first PKP was 65.4% and for the second PKP, 43.4% (p < 0.001). All cases of third PKP and fourth PKP failed within 8 years. Preoperative mean ECD (95% confidence interval) was 2722 (2666–2778) cells/mm2; it decreased exponentially after PKP. Mean ECD was 659 (440–878) cells/mm2 at 10 years. Rejection, trauma, and infection occurred significantly more frequently in failed grafts than in transparent grafts.

Conclusions

The long-term prognosis of PKP depends on the original diagnosis. The long-term prognosis of re-grafting is worse than that of primary grafts. Rejection, trauma, and infection are risk factors for graft failure.

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Acknowledgements

We would like to thank Dr. Toshihito Furukawa (Biostatistical Research CO., LTD) for statistical analyses and Editage (http://www.editage.jp) for English language editing.

Conflicts of interest

T. Ono, None; S. Ishiyama, None; T. Hayashidera, None; Y. Mori, Grants (Alcon, AMO, BD, HOYA, Mitsubishi Chemical Medience, Otsuka pharmaceutical, Santen pharmaceutical, Senju pharmaceutical), Lecture fees (HOYA, Otsuka pharmaceutical, Pfizer, Senju pharmaceutical); R. Nejima, None; K. Miyata, Grants (Alcon, AMO, HOYA, Otsuka Pharmaceutical, Santen Pharmaceutical, Senju Pharmaceutical), Lecture fees (Alcon, AMO, Chuo Sangio, HOYA, Otsuka Pharmaceutical, Senju Pharmaceutical); S. Amano, Grants (Alcon, AMO, HOYA, Otsuka Pharmaceutical, Santen Pharmaceutical, Senju Pharmaceutical), Lecture fees (Alcon, AMO, HOYA, Otsuka Pharmaceutical, Santen Pharmaceutical, Senju Pharmaceutical).

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Authors and Affiliations

  1. Miyata Eye Hospital, Miyakonojo, Japan

    Takashi Ono, Sosuke Ishiyama, Takeshi Hayashidera, Yosai Mori, Ryohei Nejima & Kazunori Miyata

  2. Inouye Eye Hospital, 4-3 Kandasurugadai, Chiyoda-ku, Tokyo, 101-0062, Japan

    Shiro Amano

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  1. Takashi Ono
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  2. Sosuke Ishiyama
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  3. Takeshi Hayashidera
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  4. Yosai Mori
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  5. Ryohei Nejima
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  6. Kazunori Miyata
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  7. Shiro Amano
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Correspondence to Shiro Amano.

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Ono, T., Ishiyama, S., Hayashidera, T. et al. Twelve-year follow-up of penetrating keratoplasty. Jpn J Ophthalmol 61, 131–136 (2017). https://doi.org/10.1007/s10384-016-0489-2

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  • DOI: https://doi.org/10.1007/s10384-016-0489-2

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