Corneal transplant rejection rate and severity after endothelial keratoplasty

被引:168
作者
Allan, Bruce D. S.
Terry, Mark A.
Price, Francis W., Jr.
Price, Marianne O.
Griffin, Neil B.
Claesson, Margareta
机构
[1] Moorfields Eye Hosp, London EC1V 2PD, England
[2] Devers Eye Inst, Portland, OR USA
[3] Price Vis Grp, Indianapolis, IN USA
[4] Cornea Res Fdn Amer, Indianapolis, IN USA
[5] Carolina Eye Associates, Pinehurst, NC USA
[6] Sahlgrens Univ Hosp, Dept Ophthalmol, Molndal, Sweden
关键词
keratoplasty; transplant; rejection; endothelial; penetrating;
D O I
10.1097/ICO.0b013e31812f66e5
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose: To examine the corneal transplant rejection rate and the rate of graft failure subsequent to rejection in the first 2 years after endothelial keratoplasty (EK) and to compare this to background data for similar cases of penetrating keratoplasty (PK). Methods: Anonymized data from consecutive cases of EK [deep lamellar (DLEK) or Descemet stripping (DSEK)] for Fuchs corneal endothelial dystrophy or pseudophakic bullous keratopathy operated on before August 2004 were collected in 4 participating centers. The number and timing of rejection episodes and cases of subsequent graft failure were recorded, together with the time to cessation of topical steroid medication. Two-year postoperative findings were compared with background data for similar patients undergoing PK recorded in the Swedish Corneal Transplant Registry. Results: Rejection episodes were less frequent after EK than PK (P = 0.035). Fifteen (7.5%) of 199 EK cases had a rejection episode in the first 2 years after surgery versus 92 (13%) of 708 PK cases. Graft failure after rejection in EK may have been less frequent than in PK (P = 0.063), with only 1 (6.7%) case of rejection after EK versus 26 (28.3%) cases of rejection after PK proceeding to graft failure. A strong trend toward continued use of low-dose topical steroid medication was observed in the EK group. Eighty percent of EK patients were still taking topical steroid medication 2 years after surgery, whereas topical steroid medication had been ceased within a year of surgery in almost all PK patients in the comparator group. Conclusions: Corneal transplant rejection is less frequent and may be less severe after EK than after PK. It is not yet clear whether these apparent differences are simply a product of relatively prolonged postoperative topical steroid cover in EK patients.
引用
收藏
页码:1039 / 1042
页数:4
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