PT  - JOURNAL ARTICLE
AU  - Pablo Sanjuán
AU  - Gemma Julio
AU  - Jennifer Bolaños
AU  - Juan Álvarez de Toledo
AU  - Gonzalo García de Oteyza
AU  - José Temprano
AU  - Rafael Ignacio Barraquer
TI  - Long-term anatomical and functional outcomes after autokeratoplasty
AID  - 10.1136/bjophthalmol-2020-316289
DP  - 2020 Aug 24
TA  - British Journal of Ophthalmology
PG  - bjophthalmol-2020-316289
4099  - http://bjo.bmj.com/content/early/2020/08/22/bjophthalmol-2020-316289.short
4100  - http://bjo.bmj.com/content/early/2020/08/22/bjophthalmol-2020-316289.full
AB  - 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.