Comparative Analysis of Clinical Outcome in Penetrating Keratoplasty Using Domestic or Imported Cornea

ABSTRACT

PURPOSE: To compare the survival of corneal grafts and the changes in endothelial cell density in penetrating keratoplasty using domestic or imported corneas. METHODS: Medical records of 236 eyes of 211 patients who underwent penetrating keratoplasty from November 2004 to August 2011 in Seoul National University Hospital and were followedup at least 1 year were retrospectively reviewed. After excluding the patients who received the combined surgeries with other surgeries except cataract surgery, the eyes were divided into 2 groups depending on the origin of donor tissue resulting in a domestic cornea group (108 eyes) and an imported cornea group (128 eyes). Recipient demographics, preoperative diagnosis, donor age, death-to-preservation time, death-to-operation time and pre-and postoperative visual acuities were compared between the 2 groups. Kaplan-Meier survival and changes in endothelial cell density were analyzed at 3, 6 and 12 months and then every year. RESULTS: The most common preoperative diagnoses were regraft and corneal opacity in the domestic and imported cornea groups, respectively, without statistical difference. Death-to-preservation time was 8.9 hours and 8.0 hours in the domestic and imported cornea groups, respectively, without statistical difference. However, death-to-operation time was longer in the imported cornea group (4.98 days) than in the domestic cornea group (2.18 days). There were no differences in pre- and postoperative visual acuities, decrease in annual changes in endothelial densities and survival up to 3 years between the 2 groups. In addition, the survival and decreased annual changes in endothelial densities were not different from each other in penetrating keratoplasty combined with cataract surgery or in penetrating keratoplasty for a corneal edema. CONCLUSIONS: Our study results suggest that clinical outcomes of the penetrating keratoplasty using imported corneas are comparable in efficacy when compared with the clinical outcomes using domestic corneas.