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Review
. 2024 Feb 29;14(1):50-58.
doi: 10.4103/tjo.TJO-D-24-00001. eCollection 2024 Jan-Mar.

Main issues in penetrating keratoplasty

Jorge L Alió  1   2 , Sana Niazi  3   4 , Farideh Doroodgar  3   4 , Jorge L Alió Del Barrio  5 , Hassan Hashemi  6 , Mohammad Ali Javadi  7
Affiliations
Review

Main issues in penetrating keratoplasty

Jorge L Alió et al. Taiwan J Ophthalmol. .

Abstract

This review explores contemporary challenges in penetrating keratoplasty (PK), focusing on technical intricacies, technological advancements, and strategies for preventing graft rejection. A systematic literature search from January 2018 to July 2023 was conducted across PubMed, Cochrane, Web of Science, Scopus, and EMBASE. The inclusion criteria comprised studies on PK and its comparison with other corneal pathologies, with emphasis on keratoconus (KC). Two independent reviewers screened studies, extracting relevant data. The review covers PK evolution, highlighting infra-red femtosecond lasers' impact on graft shapes, minimizing astigmatism, and enhancing wound healing. Graft rejection, a primary complication, is examined, detailing risk factors and preventive measures. Preoperative considerations, diagnostic techniques for rejection, and PK in KC are discussed. Postoperative care's significance, including intraocular pressure monitoring and steroid administration, is emphasized. The paper concludes with a comprehensive approach to prevent graft rejection, involving topical and systemic medications. An outlook on evolving monoclonal antibody research is presented. As the field progresses, personalized approaches and ongoing therapeutic exploration are expected to refine strategies, enhancing PK outcomes.

Keywords: Corneal surgery; graft rejection; keratoplasty; laser; penetrating; trephining.

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Conflict of interest statement

The authors declare that there are no conflicts of interests of this paper.

Figures

Figure 1
Figure 1
Preferred reporting items for systematic reviews and meta-analyses
Figure 2
Figure 2
Postpenetrating keratoplasty graft failure risk factors. PK = Penetrating keratoplasty, DALK: Deep anterior lamellar keratoplasty
Figure 3
Figure 3
Postoperative management methods
Figure 4
Figure 4
Summary of preventive, preoperative, and postoperative measures of penetrating keratoplasty. PK = Penetrating keratoplasty
See this image and copyright information in PMC

References

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