PREOPERATIVE RISK-FACTORS FOR SURFACE DISEASE AFTER PENETRATING KERATOPLASTY

We sought to identify the types of, prevalence of, and predisposing fa ctors for the development of surface keratopathy after penetrating ker atoplasty. We reviewed the records of 120 corneal grafts performed ove r a IS-month period. Twenty patients were excluded from the study. Fif ty-three men and 47 women composed the group studied. All transplants were performed by the same surgeon. Retrospective data from patients' records were gathered preoperatively and from postoperative visits at 1 week and at 1, 2, 3, and 4 months. Data included preoperative medica l and demographic data, operative time, postoperative medication regim ens, assessment of the presence and degree, if present, of punctate ep ithelial keratopathy (PEK), hurricane keratopathy, macroepithelial def ects, microcystic edema, bullous edema, and filamentary keratitis. In addition, information on the donor material was recorded. Surface dise ase and normal groups were compared to identify risk factors for the o ccurrence of surface abnormalities. Thirty-three of the patients demon strated persistent surface abnormalities. Coarse PEK was the most comm on surface abnormality in the sample studied and was most prominent in the first week after surgery. Postoperative surface keratopathy was n ot statistically associated with preoperative diagnosis, donor age, de ath-to-preservation time, preservation-to-surgery time, or donor epith elial status. However, corneal recipients in the group with surface ke ratopathy were significantly order (mean, 68.7 years) than patients in the group with no surface abnormalities (mean, 52.6 years; Mann-Whitn ey U test, p < 0.001). Although many factors may contribute to the nor mal integrity of the corneal surface after keratoplasty, recipient age is of key importance in the development of surface disease.