Postoperative Complications After Primary Adult Optical Penetrating Keratoplasty: Prevalence and Impact on Graft Survival

Purpose: To evaluate the prevalence of postoperative complications and their impact on graft Survival after primary adult optical penetrating keratoplasty (PKP). Methods: A retrospective review was done of consecutive cases of PKP performed between January 1, 1997, and December 31, 200 1, for keratoconus, corneal edema, stromal scarring, and stromal dystrophy. Results: The inclusion criteria were met by 9 10 eyes, including 464 with keratoconus, 188 with corneal edema, 175 with stromal scarring, and 83 with stromal dystrophy. One or more complications occurred in 362 eyes (39.8%). The most common complication was endothelial rejection (17.3%), followed by glaucoma worsening (15.5%), bacterial keratitis (5.8%), persistent epithelial defects (3.4%), and wound dehiscence (1.6%). There were significant differences among the surgical groups in overall prevalence of complications (P < 0.001) and with the prevalence of endothelial rejection (P = 0.01), glaucoma worsening (P < 0.001), bacterial keratitis (P = 0.04), and persistent epithelial defects (P = 0.02). Complication-associated graft failure varied significantly among the surgical groups (P = 0.02). Conclusion: The prevalence of post-PKP complications and their impact on graft survival vary significantly among surgical indications for primary adult optical PKP.