Survival of penetrating keratoplasty: a claims-based longitudinal analysis.

Objectives: To report real-world long-term survival of primary penetrating keratoplasty (PK) in the United States and analyze risk factors associated with failure.

Design: Retrospective longitudinal cohort study using a large commercial insurance database.

Participants: Ten million patients enrolled in the database from 2011 to 2017 were identified using Current Procedural Terminology codes for PK.

Methods: Kaplan-Meier survival analysis was performed to determine failure rate and risk factors impacting graft outcomes.

Results: Five hundred and ninety-six primary PKs were identified. The 3-year survival was 78% (confidence interval [CI]: 73%-82%), 5-year survival was 76% (CI: 70%-80%), and 7-year survival was 73% (CI: 66%-79%).

Conclusion: This study demonstrated a significantly lower 5-year success rate for primary PK performed for all causes than previously published case series in the United States.