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Long-term anatomical and functional outcomes after autokeratoplasty
  1. Pablo Sanjuán,
  2. Gemma Julio1,
  3. Jennifer Bolaños1,
  4. Juan Álvarez de Toledo1,
  5. Gonzalo García de Oteyza1,
  6. José Temprano1,
  7. Rafael Ignacio Barraquer1
  1. Centro De Oftalmología Barraquer, Barcelona, Spain
  1. Correspondence to Gemma Julio, Centro De Oftalmología Barraquer, c/Muntaner 314, Barcelona 08021, Spain; gemma.julio{at}


Background To evaluate the anatomical and functional outcomes of autologous contralateral penetrating keratoplasty (autokeratoplasty).

Methods Kaplan-Meier survival analyses were retrospectively performed. Anatomical failure was defined as regraft or graft permanently cloudy at any time during follow-up. Functional failure was defined as the final best-corrected visual acuity (BCVA) <20/400.

Results Thirty-one eyes of 31 patients (19 men), with a mean age of 52±18 years (range 15–81 years) were studied during a mean follow-up of 11.3 years (from 13 months to 48 years). At 12 months postoperatively, all the recipient eyes showed a transparent cornea, but 23% showed functional failure. At the final followup, 16 recipient eyes (52%) showed anatomical and functional success. Twenty-three eyes (74%) showed a clear cornea and 68% reached a better BCVA when compared with preoperative measurements. Nevertheless, 13/31 eyes (42%) displayed functional failure. The accumulative probabilities for anatomical success were 100%, 72% and 48% and 77%, 59% and 29% for functional success at 1, 10 and 40 years, respectively. The most common risk factor for failure was progression of previous glaucoma in 50% of the anatomical failures and in 77% of the functional failures.

Conclusions Autokeratoplasty could be a successful long-term option in patients having one eye with a clear cornea but with irreversible visual dysfunction and the contralateral eye having favourable visual potential limited only by a completely opacified cornea. Progression of previous glaucoma was the most important risk factor for long-term cornea decompensation and visual functional failure in the sample.

  • Cornea
  • Glaucoma

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  • Acknowledgements We thank Justin C. D’Antin and Michael J. Edel for the English edition of the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval Our IRB (Comité Etico del Centro de Oftalmología Barraquer) waived the need for IRB approval due to the retrospective nature of the study. Nevertheless, its approval was obtained for the retrospective review of the patients’ clinical record.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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