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[Functional Results and Graft Failure after Repeat Keratoplasty]
S Blug1,2, B Seitz1, A Langenbucher3
1Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, Homburg/Saar.
Klinische Monatsblatter Fur Augenheilkunde
|January 24, 2017
Summary
Repeat keratoplasty outcomes improve with excimer laser trephination for better visual acuity. Graft diameter impacts astigmatism but not survival; larger grafts are preferred when possible.
Area of Science:
- Ophthalmology
- Transplantation Surgery
- Corneal Disease
Background:
- Corneal transplantation (keratoplasty) is a common procedure, but graft failure occurs in up to 10% of patients.
- Repeat keratoplasty may be necessary due to graft failure.
- Factors influencing repeat graft success require further investigation.
Purpose of the Study:
- To identify factors affecting functional results and graft survival after repeat keratoplasty.
- To compare outcomes between different trephination methods.
- To evaluate the impact of graft size on post-operative results.
Main Methods:
- Retrospective case series of patients undergoing repeat keratoplasty.
- Data collected from January 2001 to December 2010.
- Analysis of visual acuity, intraocular pressure, endothelial cell density, corneal topography/tomography, and graft reactions.
Main Results:
- Excimer laser trephination showed significantly better corrected visual acuity (0.39 at 2 years) compared to mechanical trephination (0.16).
- Graft diameters < 7.5 mm negatively impacted post-keratoplasty astigmatism.
- Graft diameter did not significantly affect immunological graft rejection rates.
Conclusions:
- Repeat keratoplasty with excimer laser trephination offers improved functional rehabilitation when corneal morphology allows.
- Trephination method does not significantly influence graft survival.
- Optimal graft diameter for repeat keratoplasty is as large as possible but as small as necessary.
