Comparison of penetrating and endothelial keratoplasty in patients with iridocorneal endothelial syndrome: A registry study.

Abstract

BACKGROUND:

To compare graft survival of endothelial keratoplasty (EK) versus penetrating keratoplasty (PK) in patients with iridocorneal endothelial (ICE) syndrome and identify ocular features associated with graft survival.

METHODS:

Observational, prospective, cohort study. A total of 30 806 first grafts performed between 1985 and 2020 were identified through the Australian Corneal Graft Registry and included in this observational, prospective cohort study. A total of 196 eyes underwent a primary corneal graft for ICE syndrome. Kaplan-Meier graft survival plots and Chi-squared tests were performed to identify graft survival rates for EK and PK. A history of raised intraocular pressure (IOP) was also recorded and analysed. Graft survival of eyes with ICE syndrome were compared to that of other indications.

RESULTS:

Grafts performed for ICE syndrome increased to 0.8% of all cases during the 2005 to 2020 period compared with 0.5% between 1985 to 2004 (χ2 =9.35, p = 0.002). From 2010, EK surpassed PK as the preferred graft type. Survival of primary grafts in eyes with ICE syndrome was lower than for other indications (log-rank = 56.62, p < 0.001). Graft survival was higher following PK than Descemet stripping (automated) endothelial keratoplasty (DS(A)EK) (log-rank = 10.56, p = 0.001). Graft survival was higher in eyes without a history of raised IOP compared to those with a reported history of raised IOP (log-rank = 13.06, p < 0.001).

CONCLUSIONS:

ICE syndrome carries a poor prognosis for graft survival. DS(A)EK had a poorer prognosis than PK. A history of raised IOP is associated with higher risk of graft failure.

• Authors: Philipp K Roberts, Miriam Keane, Gink Yang, Elsie Chan, Damien G Harkin, Natalie McKirdy, Mark Daniell, all contributors to the Australian Corneal Graft Registry
• Journal: Clinical & experimental ophthalmology (Clin Exp Ophthalmol) 2023 Sep-Oct Vol. 51 Issue 7 Pg. 663-672 ISSN: 1442-9071 [Electronic] Australia
• PMID: 37608637 (Publication Type: Observational Study, Journal Article)
• Copyright: © 2023 The Authors. Clinical & Experimental Ophthalmology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.

Topics

• Humans
• Iridocorneal Endothelial Syndrome (diagnosis, surgery, complications)
• Prospective Studies
• Fuchs' Endothelial Dystrophy (surgery)
• Cohort Studies
• Descemet Stripping Endothelial Keratoplasty
• Visual Acuity
• Australia
• Endothelium, Corneal (surgery)
• Keratoplasty, Penetrating
• Glaucoma (surgery)
• Registries
• Graft Survival
• Retrospective Studies
• Corneal Diseases (surgery, complications)