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Sequential Bilateral Corneal Transplantation and Graft Survival
Bernhard Steger1, Elinor Curnow2, Robert Cheeseman3
1Department of Corneal and External Eye Diseases, The Royal Liverpool University Hospital, Liverpool, United Kingdom; Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria.
American Journal of Ophthalmology
|August 6, 2016
Summary
Sequential bilateral corneal transplants improve graft survival. A second corneal transplant reduced graft failure risk by 50% in the first eye for Fuchs endothelial dystrophy and keratoconus patients.
Area of Science:
- Ophthalmology
- Transplantation immunology
- Corneal diseases
Background:
- Corneal transplantation is a common procedure for vision restoration.
- Graft survival rates vary depending on the type of corneal disease and transplant procedure.
- Sequential bilateral corneal transplantation has not been fully investigated regarding its impact on graft survival.
Purpose of the Study:
- To investigate graft survival and rejection following sequential bilateral corneal transplantation.
- To determine if a second corneal transplant influences the success of the first transplant.
Main Methods:
- Retrospective cohort study including 11,822 patients undergoing corneal transplantation between 1999 and 2012.
- Patients with Fuchs endothelial dystrophy (FED), pseudophakic bullous keratopathy (PBK), or keratoconus were included.
- Outcomes measured included graft rejection or failure at 5 years post-transplant.
Main Results:
- A second corneal transplant was associated with a 50% reduced risk of graft failure in the first eye for FED and keratoconus patients.
- This protective effect was particularly pronounced in FED patients following endothelial keratoplasty (EK), with a 70% reduction in failure risk.
- No significant association was found between a second transplant and rejection episodes in the first eye.
Conclusions:
- Sequential bilateral corneal transplantation, particularly EK for FED, enhances graft survival in the first eye.
- The findings suggest a potential immune-modulatory or protective effect of the second transplant on the first graft.
- Further research may elucidate the mechanisms behind this observed benefit in corneal graft survival.
