outcomes of penetrating and lamellar kerotoplasty in patients with mustard gas keratitis

purpose: to compare clinical outcomes of two methods of corneal transplantation, penetrating keratoplasty (pk) versus lamellar keratoplasty (lk), in patients with delayed-onset mustard gas keratitis (mgk). methods: in this retrospective, comparative, interventional case series, 78 eyes of 55 victims of chemical warfare with delayed-onset mustard gas keratopathy who underwent pk or lk were enrolled. two groups were compared in terms of best spectacle-corrected visual acuity (bscva), refractive error, and keratometric readings. the cumulative incidence of pk versus lk rejection-free graft survival, as well as graft survival were used to evaluate and compare the results. results: at the time of keratoplasty, mean age was 40.3±4.5 years in the pk group and 43.8±4.3 years in the lk group (p=0.08), the patients were followed for 53.2±27.5 and 40.4±29.6 months, respectively (p=0.09). at the last follow-up, both groups were comparable in terms of to bscva (p=0.87), refraction (p=0.08), and keratometric readings (p=0.27). the rejection-free graft survival rate was 33.6% in the pk group and 90% in the lk group at 33 months with a mean length of 34.5 and 84.8 months, respectively (p<0.001). at the same follow-up examination, the graft survival rate was 77.3% and 91.7% with a mean length of 67.5 and 75.1 months, respectively (p=0.03). three eyes that had received lk required pk because of significant interface haze formation. conclusion: lk is preferred to pk in the majority of mustard gas victims. however, pk may inevitably be performed in some conditions.