Abstract
We report a retrospective analysis of the clinical indications for 3555 penetrating keratoplasties performed at our department between 1971 and 1990. The cases were distributed among 12 diagnostic categories. Regrafting was the most common indication overall, accounting for 1452 cases (40.8%). Other major indications were, in order of decreasing frequency, keratoconus (17%), scarring secondary to herpes simplex keratitis (11.7%), aphakic bullous keratopathy (5.9%) and interstitial keratitis (5%). Further analysis of the relative percentages in each category within each 5-year interval of the study period was carried out to identify any changes in incidence. Viral disease as an indication for penetrating ker-atoplasty has shown a gradual decrease in frequency, accounting for only 6.4% of the cases during the last 5-year period (1986-90) compared with 19.6% during the first 5 years (1971-75). This finding is consistent with the marked improvement in the recognition and medical treatment of herpes simplex keratitis. The increase in incidence of grafting for pseudophakic bullous keratopathy in 1986-90 (6.7%) compared with 1981-85 (1.1%) correlates well with the dramatic increase in the number of cataract extractions with intraocular lens implantations performed during that period.
Similar content being viewed by others
Article PDF
References
Smith RE, McDonald HR, Nesburn AB, Minckler DS . penetrating keratoplasty: changing indications, 1974 to 1978. Arch Ophthalmol 1980;98:1226–9.
Brady SE, Rapuans CJ, Arensten JJ, Cohen EJ, Laibson PR . Clinical indications for and procedures associated with penetrating keratoplasty, 1983-88. Am J Ophthalmol 1989;108:118–22.
Arensten JJ, Morgan B, Green WR . Changing indications for keratoplasty. Am J Ophthalmol 1976;81:313–8.
Lemp MA . Indications for penetrating keratoplasty. Med Ann DC 1972;41:346–50.
Chandler JW . Indications for penetrating keratoplasty and management of cases. Trans Pacific Coast Oto-ophthalmol Soc 1976;57:97–104.
Robin JB, Gindi JJ, Koh K, Schanzlin DJ, Rao NA, York KK, Smith RE . An update of the indications for penetrating keratoplasty, 1979-83. Arch Ophthalmol 1986;104:87–9.
Schanzlin DJ, Robin JB, Gomez DS . Results of penetrating keratoplasty for aphakic and pseudophakic bullous keratoplasty. Am J Opthalmol 1984;98:302–12.
Stark WJ, Leske MC, Worthen DM . Trends in cataract surgery and intraocular lenses in the United States. Am J Ophthalmol 1983;96:304–10.
Meyer RF, Sugar A . penetrating keratoplasty in pseudophakic bullous keratopathy. Am J Ophthalmol 1980;90:677–81.
Waring GO III, Welch SN, Cavanagh HD . Results of penetrating keratoplasty in 123 eyes with pseudophakic or aphakic corneal edema. Ophthalmology 1983;90:25–33.
Stark WJ, Maumenee AE . Update of the intraocular lens: experience at the Wilmer Institute. Ophthalmologica 1983;187:65–73.
Sharif KW, Casey TA . penetrating keratoplasty for keratoconus: complications and long term success. Br J Ophthalmol 1991;75:142–6.
Ficker LA, Kirkness CM, Rice NSC, Steele ADMcG . The changing management and improved prognosis for corneal grafting in herpes simplex keratitis. Ophthalmology 1989;96:1587–96.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sharif, K., Casey, T. Changing indications for penetrating keratoplasty, 1971–1990. Eye 7, 485–488 (1993). https://doi.org/10.1038/eye.1993.106
Issue Date:
DOI: https://doi.org/10.1038/eye.1993.106
This article is cited by
-
Veränderungen der Indikationen für die perforierende Keratoplastik, 1984–2004
Spektrum der Augenheilkunde (2004)
-
Referral patterns, treatment management and visual outcome in keratoconus
Eye (1998)
-
Changing indications for penetrating keratoplasty in the west of Scotland from 1970 to 1995
Eye (1997)
-
Adaptation to loss of a disability: A case study on gaining sight
International Journal of Rehabilitation and Health (1997)
-
The use of the same size host and donor trephine in penetrating keratoplasty for keratoconus
Eye (1994)