Fourteen total penetrating keratoplasties combined with complete or partial iris excision and lens extraction were performed during 1968 to 1969 in Malawi, Africa.
Only three patients retained clear grafts 18 months after the operation. In the rest, the grafts opacified within 1 to 18 months postoperatively.
Additional partial penetrating keratoplasty and keratoprosthesis performed on seven cases of the last group resulted in some functional improvement.
One year following the last operation, visual acuity of 10/200 or better was achieved in eight cases. Four patients developed secondary glaucoma after the operation, but this was amenable to treatment.
It appears that total penetrating keratoplasty is indicated for very unfavorable cases in which the anterior segment is severely damaged. Some functional improvement is to be expected in about 50% of the cases.
Ticho U, Ben-Sira I. Total Keratoplasty. Arch Ophthalmol. 1973;90(2):104-106. doi:10.1001/archopht.1973.01000050106006