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Purpose : This study evaluated the recurrence of corneal dystrophies after corneal transplants in an Asian cohort.
Methods : This retrospective consecutive case series studied all corneal transplants performed for stromal and bowman dystrophies in the Singapore National Eye Centre between 1991 to 2014. Clinical data, details of the cornea transplant surgery and post-operative outcomes were obtained from a database maintained by the Singapore Eye Bank. To avoid repeat counts, only one graft for each subject was analysed. The main outcome measure was the rate of dystrophy recurrence.
Results : The 63 patients studied had a variety of dystrophies, namely Lattice dystrophy (n=29, 46.0%), Granular dystrophy (n=18, 28.6%), Macular dystrophy (n=9, 14.3%), Schnyder corneal dystrophy (n=4, 6.3%) and Reis-Bücklers dystrophy (n=3, 4.8%). Twenty six (41.3%) penetrating keratoplasties, 7 (11.1%) anterior lamellar keratoplasties, 2 (3.2%) hemi-automated lamellar keratoplasties and 28 (44.4%) deep anterior lamellar keratoplasties were performed amongst these patients. The cohort had an average follow-up of 5.3 years. Overall, the recurrence free survival was 96.4% at post-operative year three. In the multivariable cox regression analysis, Granular dystrophy was more likely than Lattice dystrophy to recur (Hazards Ratio: 5.09, 95% confidence interval: 1.03- 25.21, p=0.047). Lamellar and full thickness keratoplasties had relatively similar rates of dystrophy recurrences.
Conclusion : Stromal and bowman dystrophies had a recurrence free survival of 96.4% at post-operative year three. Granular dystrophy appeared to have a higher rate of recurrence as compared to Lattice dystrophy, this might be unique to Asian populations but requires further study.
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