CATARACT FORMATION AND CATARACT-EXTRACTION AFTER PENETRATING KERATOPLASTY

Purpose: This retrospective study was done to identify risk factors fo r cataract formation and cataract extraction after penetrating keratop lasty to determine whether a combined procedure (simultaneous cataract extraction with keratoplasty) or penetrating keratoplasty alone shoul d be performed. Methods: Variables from 342 phakic eyes having undergo ne penetrating keratoplasties were studied with univariate and multiva riate analyses, including diagnosis, race, sex, age, preoperative lens opacities, preoperative vision, and length of follow-up. Results: For cataract formation, age was the only independent risk factor found by multivariate analysis (P = 0.0001). For cataract extraction after pen etrating keratoplasty, independent risk factors included age, sex, dia gnosis, and preoperative lens opacities (P less than or equal to 0.03) . For example, the probability of a 65-year-old patient with Fuchs dys trophy requiring a cataract extraction within 5 years of keratoplasty is 81%. Conclusion: The likelihood of cataract formation and cataract extraction subsequent to penetrating keratoplasty increases greatly af ter 50 years of age, regardless of the diagnosis leading to the need f or keratoplasty. The need for cataract extraction also is increased fo r female patients, for patients with Fuchs dystrophy, and for those wi th early preoperative lens opacity.