Evaluation of Surgical Outcome in Penetrating Keratoplasty in Adherent Leucoma and Leucoma Grade Corneal Opacity

Abstract

Introduction: Penetrating keratoplasty (PK) is a full-thickness corneal transplant where a diseased cornea is replaced with a donor graft. The outcome is influenced by multiple factors including donor-host compatibility, surgical precision, and follow-up care. In India, low literacy and socioeconomic barriers often hinder consistent postoperative monitoring.
Materials and Methods: This prospective observational study was conducted over 18 months at a tertiary care center. Thirty patients with unilateral corneal opacity were enrolled—15 with adherent leucoma and 15 with leucomatous corneal opacity. Both genders were included. Detailed clinical histories were taken, and comprehensive ocular evaluations, including visual acuity testing with Snellen's chart, slit-lamp biomicroscopy, and ophthalmoscopy, were conducted. Additional imaging, such as orbital X-rays and B-scan ultrasound, was used when needed. Patients were followed up regularly to assess visual improvement and monitor for complications.
Results: Of the 30 patients, 12 (40%) were male and 18 (60%) female, with mean ages of 52.8 years for leucomatous opacity and 55 years for adherent leucoma. Postoperative complications included corneal edema in 24 (80%) patients, epithelial defects in 4 (13.3%), anterior chamber reaction in 10 (33.3%), hyphema in 2 (6.6%), glaucoma in 3 (10%), loose sutures in 1 (3.3%), corneal vascularization in 3 (10%), and graft failure in 3 (10%).
Conclusion: Penetrating keratoplasty is an effective treatment for restoring vision and anatomical integrity in corneal blindness, particularly in post-traumatic and post-ulcerative cases, thereby significantly contributing to visual rehabilitation.