Prediction of Visual Outcome after Penetrating Keratoplasty for Pseudophakic and Aphakic Corneal Edema

Background and objective: To evaluate the ability to predict visual outcome after penetrating keratoplasty (PKP) in patients with pseudophakic or aphakic corneal edema (PCE or ACE). Material Methods: Medical records of 34 patients (34 eyes) who underwent PKP for PCE or ACE during 1994-2004 in Ahvaz were retrospectively analyzed for variables in the history and ocular examination before PKP and visual outcome after PKP. The predictive values of preoperative variables, including age, gender, method of intraocular lens (IOL) implantation, vitreous loss during cataract surgery, time interval between cataract and PKP, and history of glaucoma or increased intraocular pressure (IOP) before PKP, on post-PKP visual outcome were assessed using logistic regression analysis. Odds ratio (OR) with 95% confidence interval (95% CI) was calculated for the predictive factors. Results: Mean follow-up was 23.6 months. Best corrected visual acuity (BCVA) of 20/200 or better was achieved in 17 patients (50%). The strongest predictors of the outcome were time interval between cataract surgery and PKP ( p =0.008, OR= 3.50, 95% CI; 0.48-31.18), aphakia ( p =0.027, OR= 4.29, 95% CI; 0.36-114.8), and no history of glaucoma or increased IOP before PKP ( p =0.020, OR= 3.75, 95% CI; 0.71-21.41). Conclusion: In patients with PCE and ACE who are candidates for PKP, time interval between cataract and PKP of less than 20 months, no history of glaucoma or increased IOP before PKP, aphakia versus presence of IOL are associated with a better visual outcome.