Indications and Outcomes of Repeat Penetrating Keratoplasty

Purpose: To evaluate indications, risk factors and outcome of repeat penetrating keratoplasty (PKP) at a tertiary referral eye care center Methods: In this retrospective study, medical chart of patients who underwent repeat PKP at Labbafinejad Medical Center between January 2004 and December 2009 were reviewed. Results: A total of 1,859 corneal transplantations were performed on 1,624 eyes during study period. Of these, 82 cases were repeat PKP which performed on 72 eyes (6.2% of the total number of primary PKP). Seventy-two eyes had two grafts; 10 eyes had three grafts. Among major indications, keratoconus was the least common initial indication for regraft and bullous keratopathies were the most common initial indication. The percentage of graft/regraft ratio ranged from a high of 9.6% for eyes with pseudophakic bullous keratopathy (PBK) / aphakic bullous keratopathy (ABK) to a low of 1.4% for eyes with keratoconus. Eyes with PBK/ABK were significantly overrepresented as a relative contributing factor to repeat PKP compared to initial PKP (29.2% vs. 11.7%, P=0.001), while those with keratoconus were significantly under-represented (13.9% vs. 38.4%, P=0.001). Conclusion: Bullous keratopathies are the leading indication for repeat PKP in our center. It has the highest relative risk for repeat PKP in comparison to other conditions whereas, keratoconus has the least.