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Prior Contralateral Penetrating Keratoplasty Is a Risk Factor for Second Eye Graft Rejection
Eric J Shiuey1, Qiang Zhang1,2, Christopher J Rapuano1,3
1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Aims:
To determine whether prior penetrating keratoplasty (PK) in the contralateral eye increases risk of second eye PK graft rejection.
Methods:
Cohort study of 593 consecutive PKs in transplant-naïve eyes (500 unilateral cases, 93 second eyes). Outcomes were compared between PKs performed in eyes with versus without a history of prior contralateral eye PK. Risks of rejection and failure were estimated using Cox proportional hazards models.
Results:
Mean age was 53.7 ± 23.3 years; average follow-up was 4.00 ± 2.87 years. Rejection occurred in 211 (35.6%) grafts. The incidence of rejection was 34.0% in unilateral cases and 44.1% in second eyes with PK in the contralateral eye. Prior contralateral PK was a significant risk factor for graft rejection (HR = 1.42, 95% CI 1.01-2.01, p = .045).
Conclusion:
Contralateral PK is associated with increased risk of second eye graft rejection. Loss of ocular immune privilege is a possible mechanism.
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