Turkish Journal of Geriatrics 2019 , Vol 22, Issue 1
AETIOLOGY, OUTCOMES AND PROGNOSIS OF PENETRATING KERATOPLASTY PERFORMED ON PATIENTS AGED ABOVE 65 YEARS
Osman ÖNDAŞ1, Sadullah KELEŞ1, Erdinç BOZKURT2
1Ataturk University, Faculty of Medicine, Department of Ophthalmology, Erzurum, Turkey
2Kafkas University, Faculty of Medicine, Department of Ophthalmology, Kars, Turkey
DOI : 10.31086/tjgeri.2019150573 Introduction: The objective of this study is to evaluate indications, outcomes and prognosis in geriatric patients who underwent penetrating keratoplasty (PKP).

Materials and Method: 84 of 297 patients, who underwent PKP between January 2013-August 2016, were retrospectively analyzed. Age, gender, time between the onset of complaints and keratoplasty, duration of follow-up, other intraoperative-postoperative surgical procedures, complications, intraocular pressure (IOP), visual acuity were recorded. The data were statistically analyzed using paired-t test. P<0.05 was considered to be significant.

Results: 84 eyes of 84 patients-49 (58.33%) male, 35(41.67%) female, mean age 65-83 (73.5±10.8) years-were included in the study. PKP was performed due to pseudophakic bullous keratopathy (PBK) in 35 (41.67%) patients, corneal leukoma 27 (32.14%), post-traumatic corneal scar 8 (9.52%), graft failure 6 (7.14%), aphakic bullous keratopathy 5 (5.95%), corneal dystrophy 3 (3.57%). The most common indication was PBK (41.67%). 23 (65.71%) of the PBK patients had posterior chamber intraocular lens (IOL), 10 (28.57%) anterior chamber, 2 (5.71%) scleral fixation. The time between the onset of complaints and keratoplasty was 3-31years. The mean duration of follow-up was 17.7 months. Intraoperatively, extracapsular cataract extraction+IOL implantation was performed on 13 (15.47%) patients, vitrectomy+lens extraction+IOL implantation 8 (9.52%), pupilloplasty 7 (8.33%), anterior chamber IOL extraction+anterior vitrectomy 6 (7.14%). Postoperatively, re-keratoplasty was performed on 9 (10.71%), secondary IOL implantation 8(9.52%), Ahmed glaucoma valve implantation 4 (4.76%), phacoemulsification 3 (3.57%), resuturation 1 (1.19%). Postoperative graft failure was observed in 9 (10.71%) patients, glaucoma 8 (9.52%), cataract 3 (3.57%), endophthalmitis 2 (2.38%), traumatic wound dehiscence 1 (1.19%). Preoperative-postoperative visual acuity was 1.43±0.76, 0.40±0.15 (logMAR), respectively (p<0.01). Preoperative-postoperative IOP was 13.78±6.50 mmHg, 16.01±2.29 mmHg, respectively.

Conclusion: The most prevalent PKP indication in patients aged above 65 years was PBK; the results along with other surgical methods were quite satisfactory. Keywords : Geriatrics; Keratoplasty, Penetrating; Prognosis