INDICATIONS FOR PENETRATING KERATOPLASTY AND ASSOCIATED PROCEDURES, 1989-1995

Purpose. To identify changing trends in indications for penetrating ke ratoplasty and associated surgical procedures. Methods, Review of char ts from all patients who underwent penetrating keratoplasty at Wills E ye Hospital from January 1, 1989 through December 31, 1995. Results, A total of 2,442 corneal transplants were performed in 2,186 patients. The leading indication for penetrating keratoplasty was pseudophakic c orneal edema, accounting for 634 cases (26.0%); 54.7% of them were ass ociated with anterior chamber intraocular lenses, 36.4% with posterior chamber intraocular lenses, and 3.1% with iris-fixated intraocular le nses. Regraft (17.8%), Fuchs' dystrophy (15.7%), and keratoconus (13.2 %) followed pseudophakic corneal edema in frequency. Cataract extracti on, with or without intraocular lens implantation, was combined with p enetrating keratoplasty in 439 cases of 1,264 phakic eyes (34.7%). Int raocular lens exchange was performed in 285 of the 634 cases of pseudo phakic corneal edema (44.9%). Conclusion, Pseudophakic corneal edema w as the leading indication for penetrating keratoplasty, with an increa sing number of cases associated with posterior chamber intraocular len ses during the study period (p = 0.001). The number of regrafts steadi ly increased between 1989 and 1995 (p = 0.001), being the second most common indication for corneal transplantation since 1992.