Lymphatic corneal neovascularisation affects graft survival in high-risk corneal transplantation
- Nadja Franz 1, Christoph Palme 2, Alexander Franchi 3, Victoria Stöckl 1, Christof Seifarth 3, Gertrud Haas 2, Matus Rehak 1, Bernhard Steger 4
- 1Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Tirol, Austria.
- 2Department of Ophthalmology and Optometry, Medical University of Innsbruck, Innsbruck, Tirol, Austria.
- 3Ophthalmology, Medizinische Universität Innsbruck, Innsbruck, Tyrol, Austria.
- 4Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Tirol, Austria bernhard.steger@i-med.ac.at.
- 0Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Tirol, Austria.
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View abstract on PubMed
Summary
This summary is machine-generated.Lymphatic corneal neovascularisation (CoNV) significantly increases graft failure risk within two years after penetrating keratoplasty. This lymphatic CoNV typically regresses within one year, and its presence, especially with ICG leakage, signals high corneal transplant risk.
Area Of Science
- Ophthalmology
- Vascular Biology
- Transplantation Immunology
Background
- Corneal neovascularisation (CoNV) is a critical factor in corneal allograft rejection and failure.
- Understanding the role of lymphatic and haematic vascularisation in the graft bed is crucial for improving graft survival.
Purpose Of The Study
- To assess the impact of preoperative lymphatic and haematic vascularisation of the graft bed on corneal allograft survival.
- To evaluate the association between lymphatic CoNV, graft failure, and indocyanine green (ICG) angiography findings.
Main Methods
- Retrospective study of 17 patients undergoing penetrating keratoplasty (PK) with confirmed CoNV (CD-31 staining).
- Patients were grouped based on the presence (lymphatic CoNV, podoplanin staining) or absence of lymphatic CoNV.
- Follow-up was 2 years; outcome measures included graft failure and ICG angiography leakage patterns.
Main Results
- Lymphatic CoNV was present in 10 patients (group 1), who had a younger age of CoNV (0.6 years) and a higher graft failure rate (60%) compared to 7 patients with only haematic CoNV (group 2, 0% failure).
- Lymphatic CoNV was observed only in cases with CoNV younger than 12 months.
- ICG leakage correlated with a younger age of CoNV, indicating the presence of lymphatic CoNV.
Conclusions
- Preoperative lymphatic CoNV in haemvascularised corneal stromal beds elevates the risk of graft failure within two years.
- Lymphatic CoNV appears to regress within the first year post-inciting event.
- The presence of lymphatic CoNV or ICG leakage during this early period signifies a high-risk scenario for corneal transplantation.
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