Penetrating keratoplasty for silicone oil keratopathy

Purpose: Penetrating keratoplasty for silicone oil keratopathy is associate d with high risks and limited visual prognosis. This study examined the out comes and factors influencing graft failure. Methods: A retrospective, non-comparative, interventional case series of pa tients attending Moorfields Eye Hospital, London. Results: A total of 24 penetrating keratoplasties were performed in 17 pati ents (13 men and four women) from 1991 to 2000. The mean age of patients un dergoing surgery was 43.6 years (range 17-84 years, SD +/- 21.0). Silicone oil was removed before or during the time of initial penetrating keratoplas ty in nine patients (52.9%) and left in situ in eight patients (47.1%). Ten out of 24 grafts survived (41.7%). The median duration of graft survival w as 21 months (range 2 weeks-98 months) with median duration of follow up 33 months (range 2-100 months). At final follow up, the number of patients wi th a clear graft who had oil removed before or during the time of penetrati ng keratoplasty was seven out of 10 (70.0%). Risk factors for graft failure included hypotony, multiple keratoplasty, corneal neovascularization, reje ction episode, silicone oil left in situ and postoperative glaucoma. Conclusions: Management of these complex patients requires a combined appro ach from anterior segment and vitreoretinal subspecialties. The long-term s uccess of the graft can be improved if silicone oil is removed prior or dur ing the time of penetrating keratoplasty.