Recipient Risk Factors for Graft Failure in the Cornea Donor Study
| Autor: | Brad Tennant, Thomas D. Lindquist, Robin L. Gal, Mark J. Mannis, Alan Sugar, Craig Kollman, Jean Paul Tanner, Roy W. Beck, Edward J. Holland, Robert L. Schultze, Mariya Dontchev, Steven P. Dunn |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Pseudophakia genetic structures medicine.medical_treatment Fuchs Endothelial Dystrophy Glaucoma Aphakia Postcataract Aphakia Article Corneal Diseases Corneal Transplantation Double-Blind Method Risk Factors Ophthalmology Cornea medicine Glaucoma surgery Humans Prospective Studies Corneal transplantation Aged Aged 80 and over Glaucoma medication business.industry Corneal Edema Fuchs' Endothelial Dystrophy Middle Aged medicine.disease Tissue Donors eye diseases Surgery medicine.anatomical_structure Female sense organs business Follow-Up Studies |
| Zdroj: | Ophthalmology. 116:1023-1028 |
| ISSN: | 0161-6420 |
| Popis: | Purpose To identify recipient factors that may be related to risk of corneal graft failure. Design Multicenter, prospective, double-masked, controlled clinical trial. Participants One thousand ninety subjects undergoing corneal transplantation for a moderate-risk condition (principally Fuchs' dystrophy or pseudophakic corneal edema). Methods Donor corneas were assigned using a random approach without respect to recipient factors, and surgeons were masked to information about the donor cornea, including donor age. Surgery and postoperative care were performed according to the surgeons' usual routines, and subjects were followed up for 5 years. Baseline factors were evaluated for their association with graft failure. Main Outcome Measures Graft failure, defined as a regraft or a cloudy cornea that was sufficiently opaque to compromise vision for a minimum of 3 consecutive months. Results Preoperative diagnosis of pseudophakic or aphakic corneal edema increased graft failure risk approximately 4-fold compared with Fuchs' dystrophy (27% vs. 7%). Prior glaucoma surgery with preoperative glaucoma medication use substantially increased the graft failure rate. Factors not strongly associated with graft failure included age, gender, diabetes, smoking, and graft size. Conclusions The risk of graft failure is significantly increased in eyes with pseudophakic or aphakic corneal edema compared with Fuchs' dystrophy, independent of lens status, and in eyes with a history of glaucoma. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references. |
| Databáze: | OpenAIRE |
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