PENETRATING KERATOPLASTY: CASABLANCA EXPERIENCE- FIVE-YEAR REVIEW

Introduction: Penetrating keratoplasty (PK) is a surgical procedure aimed at replacing the entire thickness of the patient's cornea with that of a donor. This technique is the oldest and most common for corneal transplantation. The aim of our study is to report the experience of the adult ophthalmology services at the 20 August 1953 Hospital in Casablanca, and the ophthalmology department of the Cheikh Khalifa International University Hospital in Casablanca (CKIUH) regarding penetrating keratoplasty. Materials and Methods: This was a descriptive cross-sectional study conducted within the adult ophthalmology services of the 20 August 1953 Hospital in Casablanca, and the ophthalmology department of CKIUH, including patients who underwent penetrating keratoplasty between March 2017 and January 2022. Results and Discussion: We collected data from 189 patients, with a mean age of 42.87 years and slight male predominance. The main indication was advanced keratoconus (46%) followed by bullous keratopathy (27%). The initial visual acuity was less than 1/10 in almost all cases (88.8%). Graft rejection was observed in 14.2% of cases, and ocular hypertension and infectious complications in 4.7% of cases. Final visual acuity was greater than 3/10 (logMAR =0.52) in 65% of cases with a mean astigmatism of 4.75 diopters. Graft rejection is more frequent in cases of corneal neovascularization, in men, and less frequent in cases of keratoconus. Our study results are comparable to those in the literature, particularly regarding the indications and postoperative complications of corneal transplantation. Regular monitoring is necessary to detect and treat complications, especially neovascularization, which often precedes graft rejection. Conclusion: The results of penetrating keratoplasty remain satisfactory, provided that a precise evaluation of the surgical indication is performed, accompanied by attentive and regular postoperative monitoring aimed at optimizing visual prognosis. Currently, the challenge is to explore new avenues for lamellar keratoplasty and promote organ donation to meet the growing demand for corneal grafts. Keywords: Penetrating keratoplasty – Rejection – Cornea – Keratoconus – Bullous keratopathy.