4-year review of keratoplasty in Pakistan

From January 1, 1985 to December 31, 1988, we performed penetrating keratoplasty on 54 Pakistani patients, 38 men and 16 women, at the Postgraduate Medical Institute, Peshawar. The age of the donors ranged from 14 to 91 years and that of the recipients from 12 to 65 years. The time between enucleation and the surgery was 26 hours minimum and 72 hours maximum. Autografts were used in two patients. The size of the graft ranged from 5.5 mm to 10 mm with an average of 7 mm. Corneal scarring [35 cases, due to healed bacterial ulcer, small pox, measles, trachoma, or trauma], keratoconus [eight cases], aphakic or pseudophakic bullous keratopathy [three cases], dry eye syndrome [two cases], chemical burn [two cases], active bacterial corneal ulcer [two cases], corneal dystrophy [one case], or sclerokeratitis [one case] were the reasons for keratoplasty. After a followup period of six months to four years, 23 [42.6%] grafts remained clear. The lack of donor material of good quality, a large percentage of high risk recipient eyes, and technical surgical limitations [e.g. non-availability of viscoelastic material, fine sutures, etc.] resulted in 57.4% failure rate. Only four [7.4%] cases showed late rejection, which was successfully managed in two of them. Of the eight eyes with keratoconus, seven retained clear grafts