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Area of Science:

  • Ophthalmology
  • Transplantation Surgery
  • Corneal Diseases

Background:

  • Fibrous ingrowth is a potential complication following corneal transplantation.
  • Identifying risk factors is crucial for managing and preventing this complication in first-time recipients.

Purpose of the Study:

  • To define the risks associated with fibrous ingrowth in first-time corneal transplant recipients.

Main Methods:

  • Retrospective case-control study of patients diagnosed with fibrous ingrowth from 2002-2019.
  • Matched controls (1:2 ratio) based on surgical indication, year, method, sex, and age.
  • Histopathologic diagnosis of fibrous ingrowth from first corneal specimen.

Main Results:

  • Incidence of fibrous ingrowth in first corneal transplants was 0.6% per year.
  • Pseudophakic and aphakic corneal edema were common indications for keratoplasty.
  • Significant risk factors included ocular trauma (OR 2.94), uveitis (OR 2.73), retinal detachment/surgery (OR 2.40), glaucoma tube-shunt surgery (OR 2.70), aphakia (OR 3.02), and iris derangement (OR 10.52).

Conclusions:

  • Ocular trauma, uveitis, retinal issues, glaucoma tube-shunt surgery, aphakia, and iris derangement are identified risks for fibrous ingrowth in first-time keratoplasty.
  • Patients with these pre-existing conditions require vigilant monitoring for corneal decompensation.
  • A predictive model incorporating iris derangement, ocular trauma, uveitis, and cataract surgery history showed 81% sensitivity and 66% specificity.