SURGICAL RESULTS OF PENETRATING KERATOPLASTY IN ESSENTIAL IRIS ATROPHY

BACKGROUND: Results of penetrating keratoplasty in iridocorneal endothelial syndrome have been considered favorable based on past studies; however, documented results in eyes specifically with essential iris atrophy are lacking. METHODS: A retrospective study was performed to evaluate all patients at the University of Pittsburgh with essential iris atrophy who had undergone penetrating keratoplasty for corneal decompensation over 21 years (1971-1992). RESULTS: Penetrating keratoplasty had been performed on six eyes with essential iris atrophy for corneal decompensation. All eyes postoperatively had evidence of persistent anterior uveitis resistant to corticosteroid treatment with one or more episodes of graft reaction. Five of the six eyes (83.3%) ultimately went on to graft failure. Two of the six eyes (33.3%) rejected grafts on two separate occasions. CONCLUSIONS: Penetrating keratoplasty in essential iris atrophy was frequently associated with chronic anterior uveitis and immunologic graft failure.