INDICATIONS FOR PENETRATING KERATOPLASTY - AN 11 YEAR RETROSPECTIVE STUDY OF 2962 CASES

The authors report the course of penetrating keratoplasty (PK) in a se ries of 3 012 grafts performed at the Hotel-Dieu de Paris Ophthalmolog y Department from 1980 to 1991 ; 2 962 cas (98.5 %) could be analysed and were divided into 17 etiologic groups. In the literature, Aphakic Bullous Keratopathy (ABK) and Pseudophakic Bullous Keratopathy (PBK) a re usually considered to be the most frequent PK indication. In our se ries, they came in third place overall with 281 cases (9,5 %). There i ncidence showed a constant increase over the study period, and they be came the most frequent indication in 1991 (21.4 % versus 6.8 % in 1980 ). Keratoconus was the most frequent surgical indication with 813 case s (27.6 %). This high percentage has been reported by other research g roups. We explain our findings by a bias in the choice of corneal reci pient candidates due to a tendancy of the surgical team to give availa ble donor corneas to patients with statistically higher chances of fun ctional success. We also notice that corneal herpes sequelae, classica lly the leading cause of PK in the seventies, became the second indica tion overall and showed a decreasing tendancy between 1980 and 1991. F inally, non herpetic leucomas (8.9 %), graft failures (8.6 %), and Fuc hs dystrophy (8.3 %) showed a constant PK indication rate throughout t he study period.