Outcome of primary adult penetrating keratoplasty in a Saudi Arabian population

Abstract

Purpose: To evaluate the outcome of primary adult optical penetrating keratoplasty (PKP) in a Saudi Arabian population.

Patients and methods: A retrospective review was performed of the medical records of every Saudi Arabian patient 12 years of age or older who underwent PKP for keratoconus, corneal edema, stromal scarring, or stromal dystrophy at King Khaled Eye Specialist Hospital between January 1, 1997, and December 31, 2001, and for whom a minimum of 3 months of follow-up was available.

Results: Of 910 eyes that met the inclusion criteria, there were 464 eyes with keratoconus, 188 eyes with corneal edema, 175 eyes with stromal scarring, and 83 eyes with stromal dystrophy. The 5-year survival probability was 96.1% for keratoconus, 71.1% for stromal scarring, 85.9% for stromal dystrophy, and 40.3% for corneal edema. The most significant risk factor affecting graft survival was surgical indication (P < 0.001). Among eyes with corneal edema, increasing donor age (P = 0.004) and the occurrence of one or more complications (P < 0.001) were significantly associated with an increased risk of graft failure. Overall, improvement in vision occurred in 750 (82.4%) eyes, remained the same in 97 (10.7%) eyes, and worsened in 63 (6.9%) eyes.

Conclusion: In the Saudi Arabian population, the prognosis for graft survival and improved visual acuity is excellent for eyes with keratoconus and stromal dystrophy, good for stromal scarring, and poor for eyes with corneal edema.