Endothelial Keratoplasty After Failed Penetrating Keratoplasty: An Alternative to Repeat Penetrating Keratoplasty

Ang, Marcus; Ho, Henrietta; Wong, Chee‐Wai; Htoon, Hla Myint; Mehta, Jodhbir S.; Tan, Donald

doi:10.1016/j.ajo.2014.08.024

Cited by 70 publications

(65 citation statements)

References 42 publications

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“…The graft detachment rate for DSEK/DSAEK following PK was 10.8%, and the primary graft failure rate was 9.2%. These figures fall in the mid-range of those previously reported in cohort studies (detachment rate: 6%–57% and primary failure rate: 2%–43%) 4–6 9 10 12–18. The higher primary graft failure rate for PK-EK compared with PK-PK in our series likely reflects the greater early failure rate for EKs generally,1 7 possibly as a result of iatrogenic trauma.…”

Section: Discussionsupporting

confidence: 71%

“…Previous studies have found significantly different survival of EK following failed PK, depending on whether the second graft was larger or smaller in diameter than the first; however, results have been somewhat inconsistent 4 9 13. We found no significant difference in survival of PK-EKs, based on undersizing or oversizing the second graft in comparison with the first (p=0.87).…”

Section: Discussioncontrasting

confidence: 66%

“…However, in a previous large comparative cohort study, Ang et al 9 reported results for repeat PK versus EK following failed PK in 113 eyes with an initial indication for graft of PBK. Graft survival was better for the EKs compared with the repeat PKs (p=0.013), in contrast with our results in a comparable but smaller (n=83 eyes) cohort (p<0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Despite the potential benefits of EK,4–6 such procedures fail in the early postoperative period at a higher rate than do penetrating grafts 7 8. Recent practice has seen subsequent EK used as an alternative to repeat full-thickness transplantation 9 10. This option may be chosen when the corneal stroma and epithelium of the previous penetrating keratoplasty (PK) are still relatively healthy, but when endothelial cell loss or failure has led to a loss of vision 4.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, uncertainties remain over the influence that technical variations exert on graft survival 4 9 13. We analysed the survival and visual outcomes of DSEK/DSAEK following previous PK, in comparison to repeat PK, performed over the same time period in a national cohort.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of endothelial and penetrating keratoplasty outcomes following failed penetrating keratoplasty: a registry study

et al. 2016

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'This is the peer reviewed version of the following article: Keane MC, Galettis RA, Mills RA, Coster DJ, Williams KA; for Contributors to the Australian Corneal Graft Registry. A comparison of endothelial and penetrating keratoplasty outcomes following failed penetrating keratoplasty: a registry study. Br J Ophthalmol. 2016 Feb 18. pii: bjophthalmol-2015-307792. doi:10.1136/ bjophthalmol-2015 which has been published in final form at after a first penetrating keratoplasty (PK), with outcomes of repeat PK after a first PK.Methods 400 eyes with a second graft (65 EK, 335 PK) performed after failure of a primary PK were identified through the Australian Corneal Graft Registry, a national prospectivelyfollowed cohort. Grafts were performed after January 2008 (follow-up of the second graft extending to 6.75 years maximum). Kaplan-Meier graft survival plots were constructed and Cox proportional hazards regression was used to identify independent risk factors for graft failure. Best corrected Snellen visual acuity (BCVA) at last follow-up was compared with pregraft acuity.Results Poorer Kaplan-Meier graft survival was observed for PK-EK compared with PK-PK (log-rank=29.66, p<0.001). Variables retained in multivariate analysis as significantly influencing survival of the second graft included graft type (PK-EK or PK-PK, p<0.001), length of survival of the previous PK (global p=0.011), graft era (global p=0.018), occurrence of rejection in the second graft (p=0.005) and a history of raised intraocular pressure at any time (p=0.048), but not indication for the first graft. BCVA improved in the majority of surviving grafts and attainment of 6/12 vision was similar for both PK-EK and PK-PK groups.Conclusions Our Registry findings suggest that repeat penetrating keratoplasty may deliver a better outcome in terms of graft survival than endokeratoplasty after a failed PK that was performed initially for keratoconus or pseudophakic bullous keratopathy. For surviving grafts, visual outcomes appear equivalent across groups.3

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Section: Discussionsupporting

confidence: 71%

Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A comparison of endothelial and penetrating keratoplasty outcomes following failed penetrating keratoplasty: a registry study

et al. 2016

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Differential Survival of Penetrating and Lamellar Transplants in Management of Failed Corneal Grafts

et al. 2018

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IMPORTANCE An increasing proportion of corneal transplant procedures are undertaken for replacement of a failed previous graft. The proportion of lamellar transplant procedures has significantly increased. There are limited large-scale reports on regraft procedures that may help guide surgeons and patients in their choice of surgery. OBJECTIVE To examine the corneal transplant replacement survival rates for the 3 main indications and types of regraft surgery.

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Efficiency Encapsulation of FK506 with New Dual Self‐Assembly Multi‐Hydrophobic‐Core Nanoparticles for Preventing Keratoplasty Rejection

Wang

Huang

Zhu

et al. 2023

Adv Healthcare Materials

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Nanoparticles self‐assembled by amphiphilic copolymers for loading hydrophobic molecules are intensively investigated. However, their hydrophobic molecule‐loading capacity is low due to the limitation of hydrophobic groups in these copolymers. In this regard, new lysine oligomer‐based multi‐hydrophobic side chain polymers (MHCPs) are synthesized by polymerization of γ‐benzyl‐l glutamate N‐carboxy anhydride initiated by side‐chain primary amino groups in lysine oligomer. Each hydrophobic side chain in MHCPs can be self‐assembled by hydrophobic interaction to form multi‐hydrophobic‐core nanoparticles (MHC‐NPs) with silkworm cocoon‐, grape cluster‐, and butterfly‐like shapes (depending on hydrophobic‐side‐chains lengths). To increase their stability, MHC‐NPs are dually self‐assembled with polyethylene glycol–polyglutamic acid through charge interaction. Each hydrophobic core in MHC‐NPs serves as a carrier for hydrophobic molecules, endowing their nanostructure with high loading capacity. MHC‐NPs are employed to load tacrolimus (also known as FK506), and the loading amount is 18% and the loading efficiency is 80%, which are higher than those of previously reported nanomicelles self‐assembled by linear amphiphilic copolymers. Topical administration of FK506‐loaded nanoparticle (FK506‐NP) can significantly prolong retention of FK506 on the eye surface. FK506‐NP exhibits higher in vivo immunosuppressive effects than free FK506 and commercial FK506 eye drop, as well as a better protective effect against immunotoxicity in the corneal grafts after keratoplasty.

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Endothelial Keratoplasty After Failed Penetrating Keratoplasty: An Alternative to Repeat Penetrating Keratoplasty

Cited by 70 publications

References 42 publications

A comparison of endothelial and penetrating keratoplasty outcomes following failed penetrating keratoplasty: a registry study

A comparison of endothelial and penetrating keratoplasty outcomes following failed penetrating keratoplasty: a registry study

Differential Survival of Penetrating and Lamellar Transplants in Management of Failed Corneal Grafts

Efficiency Encapsulation of FK506 with New Dual Self‐Assembly Multi‐Hydrophobic‐Core Nanoparticles for Preventing Keratoplasty Rejection

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