Free Papers

Risk factors for postoperative complications in patients with keratoplasty according to the results of a retrospective study of the case histories of patients after keratoplasty for the period 2012-2019.

Free Paper Details

First Author: S.Sakhnov RUSSIA

Co Author(s):    V. Myasnikova   D. Nefedof   E. Afonina   T. Zakaraiia           

Abstract Details

Purpose:

Evaluation of the effectiveness of the standard patient management regimen in the surgical treatment of corneal pathology and identification of risk factors for the development of postoperative complications based on a retrospective analysis of data from patients who underwent keratoplasty in the period 2012–2019.

Setting:

Retrospective study conducted at the S Fyodorov Eye Microsurgery Federal State Institution - Krasnodar, Russia.

Methods:

Out of the 506 cases, 450 were with uncomplicated course, 56 - with various complications of the postoperative period. The data of archival case histories with an uncomplicated course (group 1, n = 70) and a complicated course (group 2, n = 51) were analyzed. Investigated: results of ophthalmological examination; clinical and laboratory parameters; characteristics of the donor material.The following stages of the postoperative period are highlighted: during hospitalization before keratoplasty, 1st month after surgery, 3rd month after surgery, 5th month after surgery, 7th month after surgery, 12th month after surgery.

Results:

Postoperative complications developed in 11% of cases. In group 2, in the 1st month after surgery, 8% of all complications were corneal erosion, 4% each - corneal graft disease, ulcer, corneal fistula, uveitis. After 5 months, corneal graft disease prevailed (25% of all complications). After 7 months more frequent developed corneal opacity (10%) and neovascularization (5%). After 12 months, scars and corneal opacity prevailed (14%). Significant risk factors in the preoperative period were: shortening of the Schirmer test (p = 0.0003); recuratoplasty (p = 0.005); baseline total corneal opacity (p = 0.03) and minimum residual corneal thickness (p = 0.03).

Conclusions:

The incidence of postoperative complications after keratoplasty was 11%. A retrospective analysis showed that postoperative complications are encountered in keratoplasty both high (ulcer, corneal fistula) and low risk (keratoconus). This is due to the patient's preoperative status, the choice of the type of surgery or non-optimal patient management in the postoperative period.

Financial Disclosure:

-