Original articleIndications, Outcomes, and Risk Factors for Failure in Tectonic Keratoplasty
Section snippets
Materials and Methods
We conducted a retrospective, nested cohort study of consecutive patients who underwent keratoplasty for tectonic indications at the Singapore National Eye Centre between January 1, 1991, and December 1, 2009. All demographic data and clinical data were obtained from the ongoing cohort of the Singapore Corneal Transplant Study (SCTS), an audited longitudinal prospective study that contains preoperative, intraoperative, and yearly postoperative follow-up clinical data on all corneal transplants
Study Cohort
There were 362 patients (362 eyes) who had tectonic keratoplasty performed during the study period. The demographics of our study cohort and the indications for tectonic surgery are described in Table 1. Most grafts were central (n = 269, 74.3%). The mean diameter of the central grafts was 6.5 to 10.5 (mean 7.5±2.4) mm, and the grafts were oversized by 0.5 to 2.0 (mean 1.6±0.6) mm. Most PK grafts were ≥9 mm (n = 63, 44.4%), and most ALK grafts were 6.5–7.0 mm (n = 60, 48%). The common surgical
Discussion
In this study of tectonic corneal grafts, we studied 2 main outcomes: tectonic and physiologic graft success. First, we found an anatomic success rate of 95.0% in eyes that had undergone tectonic corneal grafts. Patients who received central ALK or peripheral corneal grafts were more likely to require a repeated corneal graft within 3 months from the primary procedure, after adjusting for potential confounders. Patients with severe lid disease were also 6 times more likely to experience
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Manuscript no. 2011-1579.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.