Retinal Detachment Outcomes Worse Following Penetrating Keratoplasty Than Endothelial Keratoplasty

Retinal photomontage of a retinal detachment: the separationof the sensory retina from the underlying pigment epitheliu m. It markedly disturbs vision and often requires immediate surgery. This photomontage of 15 images allows all of the anterior and posterior retina to remain in focus, giving an overview of the amount of tissue detached.
Researchers evaluated visual acuities and graft prognosis for patients who experienced retinal detachment following either procedure.

The following article is a part of conference coverage from the American Academy of Ophthalmology 2020, being held virtually from November 13 to 15, 2020. The team at Ophthalmology Advisor will be reporting on the latest news and research conducted by leading experts in ophthalmology. Check back for more from the AAO 2020.

Retinal detachment rates are low following either penetrating keratoplasty (PK) or endothelial keratoplasty (EK), but it is more likely to occur in patients who undergo PK, according to research presented at the American Academy of Ophthalmology 2020 meeting. 

The investigators looked through medical records from an academic private practice in Philadelphia for PK or EK procedures performed between January 2012 and September 2018. Subsequent retinal detachments were identified via billing codes and chart reviews. Investigators evaluated these records for rates of retinal detachment and associated clinical outcomes. 

In total, 1676 PKs and 2292 EKs were included in the study. Among patients who underwent PK, the retinal detachment rate was 2.4% — significantly higher than the retinal detachment rate following EK (0.5%; P <.001). Concurrent anterior or pars plana vitrectomy at the time of transplant was associated with “significantly higher” odds of patients developing retinal detachment (odds ratio, 8.66; 95% CI, 2.98-25.18; P <.001). 

Outcomes for visual acuity were worse following PK-related retinal detachment compared with EK-related retinal detachment, but the researchers noted that this difference was not statistically significant. 

Rates of retinal detachments were low for both procedures, the research shows. However, it was significantly lower for EK compared with PK. “Eyes with retinal detachment after PK had worse visual acuity outcomes and graft prognosis compared to those with retinal detachment after EK.” 

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Borkar DS, Levin HJ, Wibbelsman TD, et al. RD rates and clinical outcomes following PK and EK. Presented at: American Academy of Ophthalmology 2020 Annual Meeting; November 13-15, 2020. Abstract PO437.