Indications, Surgical Procedures, and Vision Outcomes of Keratoplasty at Tripoli Eye Hospital, Libya

Abstract

Corneal transplantation is the most effective treatment modality for corneal blindness. All types of keratoplasty have a high success rate in restoring corneal clarity and visual rehabilitation of affected individuals. Corneal blindness represents the third most common cause globally. In contrast, a successful corneal graft can overcome the burden associated with corneal blindness. A study aimed to explore indications, types of keratoplasty, and vision outcomes at Tripoli Eye Hospital. This observational retrospective study was conducted on patients undergoing keratoplasty at Tripoli Eye Hospital from January 2021 to December 2022. 162 eyes of 162 patients underwent different types of keratoplasty. 162 eyes of the 162 patients were included in the current study, of which 88 (54.3%) were males and 74 (45.7%) were females. The mean age of the patients was (43.49 ± 21.48) years. The most common indications for keratoplasty were 80(49.3%) keratoconus, 41 (25.3%) decompensated cornea, 11 (6.8%) graft rejection, and 10 (6.1%) trauma. The most common type of surgery was PKP 63(38.8%), DALK 58 (35.8%), DMEK 28 (17.3%), and 13 (8.0%) Triple Procedure. The visual outcomes were the pre-operative keratoplasty; only 8(4.9%) eyes had a BCVA of 20/40 or better. In comparison, 28(17.2%) eyes had a BCVA ranging between 20/50 and 20/100, and the majority of eyes, 126(77.7%) had vision 20/200 or worse. In the postoperative keratoplasty, around 72(44.4%) experienced an improvement in BCVA to 20/40 or better, whereas 52(32.0%) eyes had a BCVA ranging between 20/50 and 20/100, and 38(23.4%) eyes had a vision from 20/200 or worse. After keratoplasty, our patients' main goal was to improve their quality of life through good vision outcomes. Patient education, preventive measures, and improvements in primary eye healthcare services are required to reduce the burden of cornea blindness.