Study To Evaluate The Factors Causing Graft Opacification In Penetrating Keratoplasty

Aim: A cohort study to evaluate the factors that contribute to opacification of a corneal graft following Penetrating Keratoplasty. Material and Methods: This cohort study consisted of 40 patients (40 eyes), of opacified graft after penetrating keratoplasty. Thirty patients were studied retrospective for 5 years and 10 patients prospectively for 2 years. The various clinical parameters in all the cases of opacified grafts were studied and evaluated. Graft opacification was defined as irreversible loss of central graft clarity, irrespective of the level of visual acuity. The time of graft opacification was defined as the visit at which irreversible loss of graft clarity was first documented. Apart from normal ocular and systemic history, history of previous ocular surgery, ocular surface disease, glaucoma or previous penetrating keratoplasty was noted. Ocular examination included recording BCVA, detailed slit lamp examination, fundus evaluation if possible, recording IOP and USG B scan. Follow-up was done daily for a week, then weekly for a month and subsequently monthly for a year. Steroids were continued for an average of 06 months-01 year unless the development of glaucoma prompted us to discontinue steroids. Topical 0.05% Cyclosporine was introduced in all cases to reduce the dosage of topical steroids. Data was collected and statistically analysed. Results: Pre-existing glaucoma is a risk factor for glaucoma in early postoperative period Odds Ratio-2.58). Mc-Carey Kaufman (MK) media had a positive association for graft clarity as compared to moist chamber (Odds Ratio2.8). Conclusion: Pre-existing glaucoma is a significant risk factor for post keratoplasty glaucoma resulting in graft opacification, modification of which can improve graft survival and clarity.