Indications And Outcomes Of Penetrating Keratoplasty at a Tertiary Hospital in Bangladesh
Purpose: To find out the indications and outcomes of Penetrating Keratoplasty at a tertiary eye hospital in Dhaka, Bangladesh.
Study Design: This was a retrospective hospital based study.
Place and Duration of Study: Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh from July 2011 and July 2018.
Methods: In this study, data was collected from the records of patients, who came for treatment at the cornea unit. Pre-operative evaluation and post-operative follow-up record was analyzed. Patents’ demographic information, visual acuity, management, pre and post-operative complications, follow-up visits and outcomes were recorded. A technical research team headed by a senior consultant determined the content validity and their comments were incorporated in finalizing the research instruments.
Results: A total of 213 penetrating keratoplasties (PK) were performed during the study period. The main indications were keratoconus (8.28%), Corneal scarring (41.42%), Adherent leukomas (25.59%), corneal dystrophy (3.84) and bullous keratopathy (7.25%). Rejection rates at 8 years were 5.62%. Keratoconus showed the best graft survival (79%). The percentage of patients with post-transplant best-corrected visual acuity of 6/36 at 8 years was 52%. There was a statistically significant reduced rejection rate in males.
Conclusion: Penetrating Keratoplasty is an effective treatment option for improving visual outcomes for people with visual impairment. There are many co-factors involved with a quality outcome of patients with Penetrating Keratoplasty such as immunological rejection, microbial keratitis and patient level of awareness, which continue to limit the success.
Key Words: Penetrating, Keratoplasty, Bangladesh, Keratoconus, Corneal Dystrophy.