Genest K., Brandt S., Wilhelm F., Duncker G. I. W., Bredehorn T.

Department of Ophthalmology, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, D-06097 Halle/Saale

The Mitteldeutsche Corneabank Halle (MCH) has existed since 1998. It is defined by law that for quality monitoring eye banks have to collect postoperative data after a corneal transplantation over a period. The aim is to guarantee a long graft survival by pointing out complications in time and by determining risk factors for transplantation success.
Material: Between 1998 and 2000, 341 penetrating keratoplasties (pkp) were performed at the University Eyeclinic Halle. The mean follow-up period was 12±4,7 months (max 32) for 132 eyes.
Results: The most common indications were corneal scars/dystrophies (16.6%) and pseudophakic bullous keratopathy (15.9%). HLA-matched grafts were used in 16.6%, mostly for repeated keratoplasty. A graft rejection was seen in 22.7% (mean after 8.3±3.3 months). Graft failure occurs in 15.1% (20 eyes). The graft survival (Kaplan-Meier analysis) was 87% after 12 and 63% after 32 months. Graft survival analysis was done for each of 4 indication groups. There was a significant difference (p=0.04) in graft survival (88% vs 36%) between group 1 (keratoconus/Fuchs´and other dystrophies/scars) and 4 (repeated keratoplasty/injury/acid burn). Epithelial defect (8.3%) and suture complications (6.0%) were the main complications after penetrating keratoplasty.
Conclusion: The results show the necessity of a continuous follow-up after keratoplasty in order to determine and to treat complications, especially immunological graft rejection in time. Establishing a follow-up system with more data series to collect statistical information to identify risk factors for graft failure should guarantee best corneal transplantation results.

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