PENETRATING KERATOPLASTY AT SAINT PAUL HOSPITAL MILLENNUM MEDICAL COLLEGE, ADDIS ABABA ETHIOPIA INDICATIONS AND OUTCOMES

Abstract

ABSTRACT Background: blindness is among the major public health problems in the world, acquired corneal blindness is the third leading cause of visual loss. The large proportion of blindness, mainly found in developing world, is either preventable or treatable. Penetrating keratoplasty is one of the most successful and most frequently performed solid organ transplants world-wide, which can alleviate selected cases of corneal blindness. However there are few centers that offer penetrating keratoplasty in developing countries especially in sub-Saharan Africa like Ethiopia despite the huge burden imposed by corneal blindness. In addition to these there are limited number of researches done so far that assess the common indications and outcome of PKP in such areas. Objective: To assess the indications and outcomes of penetrating keratoplasty at Saint Paul’s hospital millennium medical college, Addis Ababa; Ethiopia. Methods: This study is a retrospective cohort of patients for whom PKP was done. The medical records of patients who underwent PKP at Saint Paul’s hospital millennium medical college between September 2011 and September 2018 were retrospectively reviewed. The outcome measures were graft survival, visual acuity, and complication rates Results: A total of 56 patients underwent PKP during the study period and were included in the analysis. The most common indications for PKP surgery were post infectious corneal opacity or leucoma (44.6%) and previous graft failure (19.6%), corneal dystrophy in (10.7%), bullous keratopathy (8.9%), keratoconus (7.1%), and corneal ulcer (5.4%). The overall graft survival at 2 years follow up was 76.8%. Most of the patients present with visual acuity of sever visual impairment or being blind (78.6%).At one year patients with normal uncorrected VA 6/6-6/18 (26.8%) and those with 6/24-6/60 were (34.1%).The common complication were loose stiches (41.8%) and epithelial defect (25.5%). Conclusion: Leukoma / post infectious corneal opacity is the commonest indication for PKP in our setting. Ethical review: Ethical approval will be obtained from the SPHMMC, Ethics and Research Committee.