Effect of patient adherence to treatment on the efficacy of penetrating keratoplasty

Objective: to determine the relationship between adherence to treatment in patients who underwent penetrating keratoplasty (PKP) and corneal graft survival during 12 months of follow-up. Materials and methods. A retrospective analysis of treatment outcomes was performed in 56 patients who underwent high-risk PKP. Depending on the degree of adherence (full or partial), the patients were divided into two groups. The group of patients with full adherence included those who attended more than 90% of visits during the first year after the intervention, while the group of patients with partial adherence included those who missed more than 10% of medical visits. Results. The group of patients with full adherence was characterized by the following features: a higher proportion of women (p=0.033); on average, 7 years younger age of patients (p=0.021); and a predominance of higher education (p=0.014). A year after PKP, a favorable outcome was more often noted among patients with full adherence (74%) vs. partial adherence (48%) (p=0.046). Calculation of the odds ratio (OR 3.52; confidence interval [CI]: 1.1362-10.88; p=0.045) indicated a statistically significant role of treatment adherence as a factor in the effectiveness of keratoplasty. In the group of patients with full adherence, visual acuity was achieved on average by two lines higher to the top of the Golovin–Sivtsev table at the end of 12 months of observation (p=0.003). Conclusion. Adherence to treatment after PKP has a significant impact on corneal graft survival and clinical outcome. The development and implementation of a set of measures to increase adherence can significantly improve the level of safety and effectiveness of high-tech patient care in disabling corneal pathology.