Indications and outcome of penetrating keratoplasy in Yazd

Background: Penetrating keratoplasty (PK) is the most common tissue transplant. The indications for penetrating keratoplasty (PK) vary in different regions of the world. Objective: To determine the indications for PK and visual outcome in a primary referral center for a period of 8 years. Methods: This was a retrospective chart review of all patients who underwent penetrating keratoplasty at Shaheed Sadoughi University Eye Hospital from March 20, 1997 to April 20, 2005. From 286 procedures performed in this period, 255 records were available for evaluation. The data were analyzed regarding sex, age indication, visual outcome and rejection. Findings: The study group included 255 patients from which 141 (55.3%) were males and 114 (44.7%) females. The mean age of the patients was 59.2+19 (with a range of 5-82) years. The frequencies of leading indications for penetrating keratoplasty were as follows: keratoconus (32.9%), pseudophakic and aphakic bullous keratopathy (21.7%), corneal scar (14.1%), corneal dystrophy (11%), regrafts (10.2%) and corneal ulcer/perforation (4.7%). Other indications represented only 5.4% of the cases. Gender difference (M/F) ratio was significant for keratoconus. The average age of keratoconus group was significantly low (23.5+1.7) compared with other diagnostic group (P=0.00). Grafts carried out for keratoconus group were indicative of better visual outcome than grafts performed for other corneal pathologies. A large number of keratoconus patients (71.4%) achieved BCVA of 20/40 or higher at final follow up. Conclusions: Keratoconus remains the leading indication for corneal transplantation in our institution followed by PBK/ ABK