Ten-year follow-up of graft survival and visual outcome after penetrating keratoplasty in Sweden

Abstract

Purpose: To determine factors influencing graft survival and visual outcome 10 years after penetrating keratoplasty.

Methods: Ten-year follow-up data were obtained from a cohort of patients that represented 20% of corneal transplants in Sweden between 1996 and 1998. Multiple regression analyses (logistic and linear) were performed on graft survival and visual outcome (visual acuity and astigmatism).

Results: Of the initial 242 patients receiving a corneal transplant during 1996-1998, 140 were available at 10 years. The majority of patients lost to follow-up had the indication bullous keratopathy and many were deceased. Overall, 71% of transplants available for follow-up at 10 years were still functioning, with keratoconus showing the best result (88%) and bullous keratopathy the worst (48%). Complications during the first 2 postoperative years reduced the percentage of functioning grafts at 10 years from 84% to 50%. The visual acuity was influenced by indication and postoperative complications. The change in Snellen lines between preoperative and 10-year visual acuity for the individual patients also depended on indication and postoperative complications. Most of the changes occurred during the first 2 postoperative years. The astigmatism at 10 years was also affected by postoperative complications and in addition by the amount of astigmatism at 2 years.

Conclusion: Graft survival and visual outcome at 10 years depended on indication and postoperative complications. Most improvement of vision occurred during the first 2 years and was predictive of the 10-year visual outcome.