Visual outcome after allogenic penetrating keratoplasty

Purpose: To evaluate visual outcome after allogenic penetrating keratoplasty. Methods: The clinical non-randomized retrospective comparative interventional study included 245 patients undergoing allogenic penetrating keratoplasty for keratoconus (n=77), herpetic cortical scars (n=29), non-herpetic corneal scars (n=46), Fuchs endothelial dystrophy (n=24), and pseudophakic/aphakic bullous keratopathy (n=69). All patients were consecutively operated on by the same surgeon. The duration of follow-up had to exceed 1 year. Results: Increase in visual acuity and the best-corrected postoperative visual acuity were significantly (P<0.01) highest for the patients with keratoconus (visual acuity increase from 0.16 to 0.69), followed by those with herpetic corneal scars (from 0.18 to 0.58), Fuchs corneal endothelial dystrophy (from 0.13 to 0.48), non-herpetic cortical scars (from 0.13 to 0.36), and finally patients with pseudophakic/aphakic bullous keratopathy (from 0.05 to 0.28). The increase in visual acuity expressed in lines did not vary significantly (P>0.05) among the study groups. Visual acuity increased significantly after suture removal, with no significant (P>0.20) difference between the study groups. Visual acuity was significantly (P<0.001) and positively correlated with the diameter of the cortical graft. Multiple linear regression analysis revealed that graft size, keratometric astigmatism and reason for keratoplasty were the major factors significantly (P<0.05) influencing postoperative visual acuity. Conclusions: The main predictive factors for visual outcome after allogenic penetrating keratoplasty are reason for keratoplasty and graft size. Postoperative visual acuity is significantly the highest in keratoconus and significantly the lowest in pseudophakic/aphakic bullous keratopathy. Expressed in lines, increase in visual acuity does not differ significantly among groups of patients with different reasons for keratoplasty.