Effect of time interval between enucleation and keratoplasty on graft survival and visual outcomes

Background: The time interval between corneal enucleation and keratoplasty has been shown to influence visual outcomes in patients undergoing corneal transplantation. This study aims to evaluate how the duration between enucleation and keratoplasty impacts postoperative visual outcomes in patients undergoing penetrating keratoplasty (PK), Descemet’s stripping endothelial keratoplasty (DSEK), therapeutic keratoplasty (TK), and tectonic keratoplasty (TeKP). Aim: The aim of this study was to assess the effect of the time interval between enucleation and keratoplasty on visual outcomes in patients undergoing PK, DSEK, TK, and TeKP. Methodology: This prospective observational study was conducted at the Department of Ophthalmology, Government Medical College, Akola (tertiary eye care center), over a period of 3 years and 2 months. The study included 172 patients who underwent corneal transplantation with corneas stored in McCarey–Kaufman (MK) medium. Visual outcomes were assessed on postoperative days (PODs) 1, 7, and 30, 6 months, and 1 year. Data regarding patient demographics, time intervals between enucleation and transplantation, and type of keratoplasty were collected. Results: The results showed a significant improvement in visual outcomes over time, with the mean visual acuity (logMAR) improving from 1.378 on POD 1 to 0.937 on POD 30 ( P < 0.001). TK showed the poorest visual outcomes, while DSEK demonstrated the best outcomes. The time interval between enucleation and keratoplasty was correlated with the visual outcome, with shorter intervals showing better results. Conclusion: Shorter intervals between corneal enucleation and keratoplasty lead to better postoperative visual outcomes. DSEK provides the best visual outcomes, followed by penetrating keratoplasty.