Evaluation and comparison of long-term outcomes of keratoplasty in adult and geriatric patient groups

This study aimed to compare the long-term results of keratoplasty between adult and geriatric patients. A retrospective analysis was performed 751 patients who underwent keratoplasty at Akdeniz University between January 2004 and January 2025. Patients aged 18–64 years were classified as adults (Group 1, n = 566), while those aged ≥ 65 years were classified as geriatric (Group 2, n = 185). Data collected included demographic characteristics, indications, surgical details, visual outcomes, graft survival, and postoperative complications. The most common indication in adults was keratoconus, whereas bullous keratopathy predominated in the geriatric group. Postoperative best-corrected visual acuity was significantly higher in adults. Penetrating keratoplasty was the most frequently performed technique in both groups, though deep anterior lamellar keratoplasty was more common in adults. Graft rejection was significantly more frequent in geriatric patients, while postoperative glaucoma incidence did not differ between groups. Overall, graft survival and visual outcomes were more favorable in adults. These findings suggest that patient age and comorbidities should be considered when planning keratoplasty and emphasize the importance of tailored postoperative management in the geriatric population.