CORNEAL GRAFT-SURVIVAL AND VISUAL OUTCOME - A MULTICENTER STUDY

Purpose: The Corneal Transplant Follow-up Study has followed 2385 corn eal transplants performed in the United Kingdom and the Republic of Ir eland for up to 450 days to quantify factors influencing corneal graft survival and visual outcome 3 and 12 months postoperatively. Methods: Multifactorial analyses of grafts registered by United Kingdom Transp lant Support Service from July 1987 to June 1990 were used. Corrected visual acuity of functioning grafts was assessed at 3 and 12 months. R esults: Of 2385 corneal transplants followed, 214 failures were observ ed: graft survival was 95% at 3 months and 89% at 1 year. Similar fact ors affected outcome at each time. Decreased risk of failure was assoc iated with surgeons reporting most grafts, and increased risk was asso ciated with regrafts, patients younger than 10 years of age, nonvisual reasons for grafting, endothelial failure, and deep vascularization. Visual outcome was worse in older patients and was associated with cos metic reasons for grafting, superficial vascularization preoperatively , and secondary endothelial failure. Visual acuity was better when the other eye had been grafted previously, or when the diagnosis was kera toconus or stromal dystrophy. Conclusions: Primary endothelial failure was associated with high failure rates but good visual results when f unctioning. Most other factors had similar effects on both outcome mea sures. Improved outcome under highest-reporting surgeons was slight, a nd indicated possible differences in postoperative care.