Clinical ScienceTen-Year Follow-up of Graft Survival and Visual Outcome After Penetrating Keratoplasty in SwedenClaesson, Margareta MD, PhD; Armitage, W John PhDAuthor Information From the Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden; and the Department of Clinical Sciences, University of Bristol, Bristol, United Kingdom. Received for publication June 6, 2008; revision received January 12, 2009; accepted February 25, 2009. Supported by the Herman Svenssons Fund. Reprints: Dr. Margareta Claesson, MD, PhD, Department of Ophthalmology, Sahlgrenska University Hospital, S-431 80 Mölndal, Sweden (e-mail: email@example.com). Cornea: December 2009 - Volume 28 - Issue 10 - p 1124-1129 doi: 10.1097/ICO.0b013e3181a2a7a6 Buy Metrics Abstract Purpose: To determine factors influencing graft survival and visual outcome 10 years after penetrating keratoplasty. Methods: Ten-year follow-up data were obtained from a cohort of patients that represented 20% of corneal transplants in Sweden between1996 and1998. Multiple regression analyses (logistic and linear) were performed on graft survival and visual outcome (visual acuity and astigmatism). Results: Of the initial 242 patients receiving a corneal transplant during 1996-1998, 140 were available at 10 years. The majority of patients lost to follow-up had the indication bullous keratopathy and many were deceased. Overall, 71% of transplants available for follow-up at 10 years were still functioning, with keratoconus showing the best result (88%) and bullous keratopathy the worst (48%). Complications during the first 2 postoperative years reduced the percentage of functioning grafts at 10 years from 84% to 50%. The visual acuity was influenced by indication and postoperative complications. The change in Snellen lines between preoperative and 10-year visual acuity for the individual patients also depended on indication and postoperative complications. Most of the changes occurred during the first 2 postoperative years. The astigmatism at 10 years was also affected by postoperative complications and in addition by the amount of astigmatism at 2 years. Conclusion: Graft survival and visual outcome at 10 years depended on indication and postoperative complications. Most improvement of vision occurred during the first 2 years and was predictive of the 10-year visual outcome. Copyright © 2009 Wolters Kluwer Health, Inc. All rights reserved.