Email updates

Keep up to date with the latest news and content from BMC Ophthalmology and BioMed Central.

Open Access Research article

Indications and outcome of repeat penetrating keratoplasty in India

M Vanathi, Namrata Sharma, Rajesh Sinha, Radhika Tandon, Jeewan S Titiyal and Rasik B Vajpayee*

Author Affiliations

Rajendra Prasad Centre For Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

For all author emails, please log on.

BMC Ophthalmology 2005, 5:26  doi:10.1186/1471-2415-5-26

Published: 2 November 2005

Abstract

Background

Repeat penetrating keratoplasty is quite often required as there is high chance of failure of the primary graft particularly in the developing world. We planned a study to analyze the indications and outcome of repeat penetrating keratoplasty in a tertiary care centre in India.

Methods

A retrospective analysis of all the patients who underwent repeat penetrating keratoplasty, between January 1999 and December 2001 was performed. The parameters evaluated were indication for the primary penetrating keratoplasty, causes of failure of the previous graft, and final visual outcome and clarity of the repeat corneal grafts.

Results

Of fifty-three eyes of 50 patients with repeat penetrating keratoplasty (three patients underwent bilateral corneal regrafts), 37 eyes had undergone one regraft each, 14 eyes two regrafts and two eyes had three regrafts. The follow-up of the patients ranged from one to three years. The most common primary etiologic diagnosis was vascularized corneal scars (66%), of which the scars related to infection were most common (68.5%). Twenty-eight regrafts (52.8%) remained clear at a mean follow-up of 1.54 ± 0.68 years, of which 25 were single regrafts (89.3%). The commonest cause of failure of regraft was infection to the corneal graft (recurrence of herpetic infection in 9 eyes and perforated graft ulcers in 3 eyes). Three (18.6%) of the 16 eyes with multiple corneal regrafts achieved a BCVA of 6/60. Overall, only five eyes (all with single regraft) achieved a BCVA of 6/18 or better at the end of follow-up.

Conclusion

Graft infection is the leading cause of failure of repeat keratoplasty in this part of the world. Prognosis for visual recovery and graft survival is worse in eyes undergoing multiple regrafts.