J Korean Ophthalmol Soc.
2021 Jan;62(1):12-20. 10.3341/jkos.2021.62.1.12.
Patients at High Risk for Failure of Penetrating Keratoplasty
- Affiliations
-
- 1Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 2Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea
- 3Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 4Department of Ophthalmology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 5Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- KMID: 2511520
- DOI: http://doi.org/10.3341/jkos.2021.62.1.12
Abstract
- Purpose
We report the clinical characteristics and the primary underlying diseases of patients at high risk for failure of penetrating keratoplasty (PKP) in Korea.
Methods
Patients at high risk of PKP failure among those who visited the ophthalmological clinics of tertiary care hospitals in Korea from April 2019 to April 2020 and who were indicated for PKP were retrospectively enrolled. We epidemiologically investigated 119 eyes of 104 patients via medical chart review.
Results
Herpes simplex virus (HSV) keratitis was the most common primary underlying disease (26.1%). The most common primary cause of poor bilateral visual acuity was Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) (41.7%) followed by chemical burns (19.4%). Of the 119 eyes, 40.3% had a history of previous PKP and 20.2% had undergone three or more PKP. The average number of prior PKPs was 1.02 ± 1.46. Corneal neovascularization and corneal opacity were reported in 82.4 and 92.4% of cases, respectively. As the severity of these conditions increased, the eye distributions became larger. Of all patients, 47.9 and 31.9%, respectively, received the highest corneal neovascularization and corneal opacity scores.
Conclusions
Our study of patients at high risk of PKP failure improves our understanding of the relevant clinical characteristics and primary underlying diseases. Such patients require careful observation and aggressive treatment. Possible alternatives to PKP should be considered if PKP consistently fails. This study will aid clinicians in deciding whether to proceed to surgery if a poor postoperative prognosis is predictable.
