Risk factors for corneal graft rejection after penetrating keratoplasty for keratoconus.

Autor: Alsubaie H; Anterior Segment Division, King Khaled Eye Specialist Hospital, Al Urubah Rd, 11462, Riyadh, Saudi Arabia., Alrubaian A; Anterior Segment Division, King Khaled Eye Specialist Hospital, Al Urubah Rd, 11462, Riyadh, Saudi Arabia.; Department of Ophthalmology, College of Medicine, Al-Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia., Ahmad K; Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia., Ahad MA; Anterior Segment Division, King Khaled Eye Specialist Hospital, Al Urubah Rd, 11462, Riyadh, Saudi Arabia. mahad@kkesh.med.sa.
Jazyk: angličtina
Zdroj: International ophthalmology [Int Ophthalmol] 2024 Jun 27; Vol. 44 (1), pp. 286. Date of Electronic Publication: 2024 Jun 27.
DOI: 10.1007/s10792-024-02955-8
Abstrakt: Purpose: To evaluate the association between donor-related factors and the risk of rejection in patients undergoing penetrating keratoplasty (PKP) for keratoconus.
Methods: A retrospective review was performed of keratoconus patients with no corneal neovascularization who underwent PKP from November 2014 to December 2016 and completed at least two years of follow-up. Preoperative, donor, operative, and postoperative data were collected and analyzed to identify factors leading to corneal graft rejection.
Results: A total of 201 eyes (of 201 patients) that underwent PKP for keratoconus were included. Of these, 22.9% (95% CI 17.6-29.2%) had an episode of graft rejection. The overall graft survival rate was 98.5%. Receipts with a history of corneal transplant in the fellow eye (IRR 1.69, 95% CI 1.01, 2.80; p = 0.044) and those with postoperative stromal neovascularization (IRR 2.51, 95% CI 1.49, 4.21; p = 0.001) had a significantly higher incidence of rejection than those without these features. In univariate analysis, death-to-surgery time and death-to-excision time (DET) showed a weak association with graft rejection (p 0.05 and 0.08 respectively); However, in the multivariable analysis, this significance was lost. Grafts with a death-to-excision time (DET) greater than 8 h had a 0.53X lower risk of rejection compared with grafts with DET within 8 h or less (p = 0.05). Rejection was higher in patients receiving grafts with a preservation time within 7 days or less compared with preservation time greater than 7 days (30.6% vs. 21.2%, respectively, p = 0.291).
Conclusion: In the multivariable analysis, none of the donor-related factors were significantly associated with graft rejection; however, short death-to-surgery time may be associated with rejection after PKP. Recipients with a history of PKP in the fellow eye and those who developed corneal neovascularization were also at increased risk of developing rejection after keratoplasty.
(© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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