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Risk factors for corneal graft failure
F W Price1, W E Whitson, S Johns
1Corneal Consultants of Indiana, Indianapolis, USA.
Journal of Refractive Surgery (Thorofare, N.J. : 1995)
|January 1, 1996
Summary
Previous graft failure is the main risk for repeat failure in penetrating keratoplasty. Surgeons can control recipient corneal diameter to reduce immunologic rejection and improve graft survival.
Area of Science:
- Ophthalmology
- Transplantation immunology
Background:
- Penetrating keratoplasty is a common and successful ophthalmic surgery.
- Certain risk factors for graft failure remain debated.
Purpose of the Study:
- To identify donor and recipient risk factors for penetrating keratoplasty graft failure.
- To investigate factors influencing secondary graft failure and immunologic rejection.
Main Methods:
- A retrospective study of 1819 penetrating keratoplasties at a single center.
- Analysis of donor and recipient characteristics, including preoperative and postoperative data.
- Mean follow-up of 2.3 years, with 7.7% of eyes lost to follow-up.
Main Results:
- Previous graft failure was the strongest predictor of secondary failure (P = .0013).
- Patient factors like race, age, iris color, preoperative glaucoma medication use, stromal vascularization, and host horizontal corneal diameter were significant for secondary failures.
- Immunologic rejection was linked to horizontal corneal diameter, donor size, and trephination size.
Conclusions:
- Recipient horizontal corneal diameter is a novel, controllable risk factor for immunologic graft rejection.
- Managing recipient corneal diameter may help prevent graft failure after penetrating keratoplasty.