A team of Japanese researchers recently found that repeat penetrating keratoplasty (PK) to treat graft failure provides relatively safe and effective surgical outcomes for at least three years.

The retrospective study evaluated 96 cases that underwent repeat PK with a post-op follow-up period of at least three years. The team assessed surgical outcomes, including donor graft survival rates, endothelial cell densities, best-corrected visual acuities (BCVAs) and complications.

They found that the donor graft survival rates were 91%, 75% and 64%, and the mean endothelial cell densities in those survived grafts were 1,778 cells/mm2, 1,207 cells/mm2 and 989 cells/mm2 at one, three and five years post-op, respectively.

They note that BCVAs over 20/200 and 20/40 were achieved in 71% and 27% of patients, respectively, at one year post-op, in 59% and 31% of patients, respectively, at three years post-op and in 53% and 29% of patients, respectively, at five years post-op.

The team adds that the most common complication for repeat PK was the need for additional glaucoma surgery, and the highest risk factors for graft failure in repeat PK were a previous glaucoma surgery and a rejection episode. 

Kitazawa K, Wakimasu K, Kayukawa K, et al. Moderately long-term safety and efficacy of repeat penetrating keratoplasty. Cornea. 2018;37(10):1255-9.