CHANGING INDICATIONS FOR PENETRATING KERATOPLASTY, 1989-1993

The purpose of this study was to identify new trends in the changing i ndications for penetrating keratoplasty. We retrospectively reviewed t he clinical and pathologic diagnoses of 1,104 corneal buttons that had been submitted to the Estelle Doheny Eye Pathology Laboratory, Los An geles, during the 5-year period 1989-1993. The leading indications, in order of decreasing frequency, were pseudophakic corneal edema (24.8% ), regrafts (21.3%), scarring with or without chronic inflammation (11 .1%), keratoconus (7.1%), aphakic corneal edema (6.4%), and ulcerative conditions (5.8%). The incidence of pseudophakic corneal edema remain ed stable over the study period and was actually surpassed by regraft in the last year of the study. Although pseudophakic corneal edema re mains the predominant indication for penetrating keratoplasty, our fin dings suggest that its occurrence rate has begun to level off.