Survey of Rejection Prophylaxis Following Suture Removal in Penetrating Keratoplasty in Germany.

Autor:	Heinzelmann S; Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland., Böhringer D; Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland., Maier PC; Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland., Seitz B; Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Homburg (Saar), Deutschland., Cursiefen C; Zentrum für Augenheilkunde, Universitätsklinikum Köln, Deutschland., Maier AB; Klinik für Augenheilkunde, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany., Dietrich-Ntoukas T; Klinik für Augenheilkunde, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany., Geerling G; Augenklinik, Universitätsklinikum Düsseldorf, Deutschland., Viestenz A; Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle (Saale), Deutschland., Pfeiffer N; Augenklinik und Poliklinik, Universitätsmedizin Mainz, Deutschland., Reinhard T; Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland.
Jazyk:	English; German
Zdroj:	Klinische Monatsblatter fur Augenheilkunde [Klin Monbl Augenheilkd] 2021 May; Vol. 238 (5), pp. 591-597. Date of Electronic Publication: 2021 Feb 25.
DOI:	10.1055/a-1353-6149
Abstrakt:	Background: Penetrating keratoplasty (PK) gets more and more reserved to cases of increasing complexity. In such cases, ocular comorbidities may limit graft survival following PK. A major cause for graft failure is endothelial graft rejection. Suture removal is a known risk factor for graft rejection. Nevertheless, there is no evidence-based regimen for rejection prophylaxis following suture removal. Therefore, a survey of rejection prophylaxis was conducted at 7 German keratoplasty centres. Objective: The aim of the study was documentation of the variability of medicinal aftercare following suture removal in Germany. Methods: Seven German keratoplasty centres with the highest numbers for PK were selected. The centres were sent a survey consisting of half-open questions. The centres performed a mean of 140 PK in 2018. The return rate was 100%. The findings were tabulated. Results: All centres perform a double-running cross-stitch suture for standard PK, as well as a treatment for rejection prophylaxis with topical steroids after suture removal. There are differences in intensity (1 - 5 times daily) and tapering (2 - 20 weeks) of the topical steroids following suture removal. Two centres additionally use systemic steroids for a few days. Discussion: Rejection prophylaxis following PK is currently poorly standardised and not evidence-based. All included centres perform medical aftercare following suture removal. It is assumed that different treatment strategies show different cost-benefit ratios. In the face of the diversity, a systematic analysis is required to develop an optimised regimen for all patients. Competing Interests: The authors declare that they have no conflict of interest./Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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