ABSTRACT

Purpose:

To assess the prognosis of penetrating keratoplasty in corneal stromal dystrophies.

Methods:

Between January 1995 and December 2005, fifty seven eyes of 46 patients who received a corneal transplant for corneal stromal dystrophy were investigated retrospectively. Data were analized with respect to graft clarity, complications, visual acuity and recurrence of dystrophy.

Results:

The study population consisted of 9 eyes (15.8%) with lattice dystrophy, 18 eyes (31.6%) with granular dystrophy, 30 eyes (52.6%) with macular dystrophy. After a mean follow-up of 26,3 ± 19,6 (range; 6-98) months, the graft remained clear in 48 eyes (84.2%). The most common factor for graft failure was recurrent dystrophy. There was a recurrence in 4 eyes (44.5%) with lattice, after a mean interval of 39.25 ± 5.56 (range; 33-46) months, and in 6 eyes (33.4%) with granular dystrophy, after a mean interval of 36 ± 17.79 (range; 17-65) months. Two eyes (6.7%) with macular dystrophy had a recurrence at 76 and 85 months. A clinically significant recurrence, defined as the biomicroscopic findings of recurrent disease located centrally within the graft with decreased two or more lines visual acuity, occurred in 5 eyes (5/6) with granular dystrophy and one eye (1/4) with lattice dystrophy. There wasn't any clinically significant recurrence in eyes with macular dystrophy. A final refracted visual acuity of 20/100 or better was achieved in 43 eyes (75.4%).

Conclusions:

The most important factor influencing the success of the penetrating keratoplasty was recurrent disease in granular and lattice dystrophy. Recurrence is infraquent in macular dystrophy.