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Bilateral penetrating keratoplasty for keratoconus
S J Tuft1, W M Gregory, C R Davison
1Department of Epidemiology, Medical Oncology Unit, Guy's Hospital, London, England.
Ophthalmology
|March 1, 1995
Summary
Bilateral penetrating keratoplasties (PK) for keratoconus show that contralateral grafts increase rejection risk in the first eye. However, the second grafted eye demonstrates improved rejection-free survival, especially with longer intervals between surgeries.
Area of Science:
- Ophthalmology
- Transplantation Surgery
Background:
- Penetrating keratoplasty (PK) is a common surgical procedure for keratoconus.
- Understanding factors influencing graft survival is crucial for patient outcomes.
Purpose of the Study:
- To investigate the impact of bilateral surgery on rejection-free survival in penetrating keratoplasties (PK) for keratoconus.
- To identify factors affecting graft survival in eyes undergoing PK for keratoconus.
Main Methods:
- Retrospective review of 587 patients undergoing PK for keratoconus over 7 years.
- Multivariate analysis of 400 patients' data to identify factors influencing graft survival.
- Actuarial analysis of graft survival in 165 patients with bilateral grafts.
Main Results:
- Host trephine diameter >7.50 mm and severe allergic eye disease increased rejection risk in first grafts (P < 0.01).
- Contralateral PK increased rejection risk in the first grafted eye, persisting up to 6 years post-surgery.
- Rejection in the first eye elevated rejection risk in the second eye (P < 0.001), yet the second eye showed significantly better rejection-free survival (P < 0.001).
Conclusions:
- Host trephine diameter, severe allergic eye disease, and contralateral graft surgery are key determinants of rejection risk in the index eye.
- The second grafted eye in bilateral PK exhibits enhanced rejection-free survival, with risk decreasing as the interval between surgeries increases.