A Multivariable Analysis of Corneal Transplantation, Clarity of Grafts

Cherry, P.M.H.; Pashby, Robert C.; Tadros, M L; Wolf, Armin; Chipman, Mary L.; Basu, P. K.; Dixon, William S.; Hunter, W. H.; Thompson, Graeme

doi:10.1016/0002-9394(76)90566-3

Cited by 13 publications

(15 citation statements)

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“…Otherwise, IOP peaks were observed, on average, 70 days and 212 days postoperatively in half and a quarter of eyes, respectively. 10 Glaucoma is often cited as an important cause for graft failure, 12,14,16,24,[32][33][34][35][36][37][38][39] and has been reported as one of the top three most common causes along with rejection and infection. 5,14,24,40 This association is maintained even after adjustments for other risk factors.…”

Section: Penetrating Keratoplastymentioning

confidence: 99%

Corneal Transplantation and Glaucoma

Haddadin

Chodosh

2014

Seminars in Ophthalmology

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Glaucoma is the leading cause of irreversible vision loss post-keratoplasty and an important cause of graft failure. With newer techniques, such as lamellar, endothelial, and laser-assisted keratoplasty as well as keratoprosthesis gaining popularity, clinicians will need to consider the incidence, risks, evaluation, and management of glaucoma for each type of keratoplasty when determining which type of transplant may be most appropriate. A comprehensive literature search of glaucoma in the setting of corneal transplantation was performed and serves as the basis for this review. Preexisting glaucoma and aphakia are notable risk factors. Patients that are candidates for deep anterior lamellar keratoplasty may benefit from reduced rates of post-keratoplasty glaucoma. Although glaucoma also complicates eyes with Descemet stripping endothelial keratoplasty, the severity is less and the intraocular pressure is more easily controlled when compared to penetrating keratoplasty. Endothelial keratoplasty creates unique perioperative issues mostly related to management of anterior chamber air bubbles.

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Section: Penetrating Keratoplastymentioning

confidence: 99%

Corneal Transplantation and Glaucoma

Haddadin

Chodosh

2014

Seminars in Ophthalmology

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“…The possibility of glaucoma escalation after surgery or likelihood of graft failure should be discussed preoperatively. Patients with a prior history of glaucoma are more likely to have increased IOPs post-operatively and to develop graft failure compared with those without a glaucoma history [31,34,[36][37][38][39][40][41][42][43][44].…”

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confidence: 99%

Graft failure: III. Glaucoma escalation after penetrating keratoplasty

Greenlee

Kwon

2008

Int Ophthalmol

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Glaucoma after penetrating keratoplasty is a frequently observed post-operative complication and is a risk factor for graft failure. Penetrating keratoplasty performed for aphakic and pseudophakic bullous keratopathy and inflammatory conditions are more likely to cause postoperative glaucoma compared with keratoconus and Fuchs' endothelial dystrophy. The intraocular pressure elevation may occur immediately after surgery or in the early to late postoperative period. Early postoperative causes of glaucoma include pre-existing glaucoma, retained viscoelastic, hyphema, inflammation, pupillary block, aqueous misdirection, or suprachoroidal hemorrhage. Late causes include pre-existing glaucoma, angle-closure glaucoma, ghost cell glaucoma, suprachoroidal hemorrhage, and steroid-induced glaucoma. Determining the cause of IOP elevation can help guide therapeutic intervention. Treatments for refractory glaucoma include topical anti-glaucoma medications such as beta-adrenergic blockers. Topical carbonic anhydrase inhibitors, miotic agents, adrenergic agonists, and prostaglandin analogs should be used with caution in the post-keratoplasty patient, because of the possibility of corneal decompensation, cystoid macular edema, or persistent inflammation. Various glaucoma surgical treatments have reported success in post-keratoplasty glaucoma. Trabeculectomy with mitomycin C can be successful in controlling IOP without the corneal toxicity noted with 5-fluorouracil. Glaucoma drainage devices have successfully controlled intraocular pressure in postkeratoplasty glaucoma; this is, however, associated with increased risk of graft failure. Placement of the tube through the pars plana may improve graft success compared with implantation within the anterior chamber. In addition, cyclophotocoagulation remains a useful procedure for eyes that have refractory glaucoma despite multiple surgical interventions.

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“…Recipient factors reported to influence the chance of success include preoperative diagnosis, a history of previous graft failure (Harbour & Stern 1983), the presence of other eye disease such as glaucoma or corneal vascularization (Foulks 1987), and possibly age (Cherry et al 1979). Age may explain graft success in this study by association with other variables, since some common diagnoses (e.g., keratoconus) had both a very good prognosis and occurred in younger patients.…”

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confidence: 85%

The effects of donor age and cause of death on corneal graft survival

Chipman

Basu

Willett

et al. 1990

Acta Ophthalmologica

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The Ontario Corneal Recipient Registry followed 299 recipients of 326 corneal transplants performed between October 1985 and October 1987. This report describes the joint effects of donor age and cause of death on subsequent graft survival in these procedures up to two years after surgery. Cox regression analysis established that grafts from donors dying of injury experienced half the risk of graft failure of those from donors dying of heart disease or other natural causes (P less than 0.05). Although donor age differed substantially between these causes of death, controlling for donor age did not alter the association. There were no statistically or clinically significant differences in graft survival associated with either donor age or recipient age. These results suggest that the health of the donor and the circumstances surrounding death may influence the quality of corneal tissue, and deserve more attention and detailed study.

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A Multivariable Analysis of Corneal Transplantation, Clarity of Grafts

Cited by 13 publications

References 0 publications

Corneal Transplantation and Glaucoma

Corneal Transplantation and Glaucoma

Graft failure: III. Glaucoma escalation after penetrating keratoplasty

The effects of donor age and cause of death on corneal graft survival

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