The Effect of Donor- and Recipient-Related Factors on Corneal Graft Survival in Penetrating Keratoplasty

Gediz, Feyza; Yüksel, Bora; Küsbeci, Tuncay; Akmaz, Okan; Kartı, Ömer

doi:10.1080/08820538.2018.1549681

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…Most studies report low rates of graft failure after an episode of rejection in keratoconus patients. (9) Graft survival in our study was 98.5%, which is consistent with previous literature. ( An interesting observation in the current study was an association of graft rejection with DET.…”

Section: Discussionsupporting

confidence: 92%

Risk Factors for Corneal Graft Rejection after Penetrating Keratoplasty for Keratoconus

Alsubaie,

Alrubaian,

Ahmad

et al. 2023

Preprint

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Purpose To evaluate the association between donor-related factors and the risk of rejection in patients undergoing penetrating keratoplasty (PKP) for keratoconus. Methods A Retrospective review was performed of keratoconus patients with no corneal neovascularization who underwent PKP from November 2014 to December 2016 and completed at least two years of follow-up. Preoperative, donor, operative, and postoperative data were collected and analyzed to identify factors leading to corneal graft rejection. Results Among the 201 patients (201 eyes) who underwent PKP, 46 patients (22.9%) had an episode of graft rejection. The graft survival rate was 98.5%. Grafts with a death-to-excision time (DET) greater than 8 hours had a 0.53X lower risk of rejection compared with grafts with DET within 8 hours or less (P = 0.05). Rejection was higher in patients receiving grafts with a preservation time within 7 days or less compared with preservation time greater than 7 days (30.6% vs. 21.2%, respectively, P = 0.291). The rejection rate was higher in patients with a history of corneal transplant in the fellow eye than those without keratoplasty in either eye (32.7% vs. 19.2%, respectively; P = 0.077). Graft rejection was 2.4 times higher if recipients developed postoperative stromal neovascularization (P = 0.003). Conclusion Short DET could be an independent risk factor for rejection after PKP. There were no strong correlations between graft rejection and donor age, donor/recipient gender, or graft size.

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Section: Discussionsupporting

confidence: 92%

Risk Factors for Corneal Graft Rejection after Penetrating Keratoplasty for Keratoconus

Alsubaie,

Alrubaian,

Ahmad

et al. 2023

Preprint

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“…Each stage strikes the corneal endothelium to some degree, with surgical trauma being an important factor in the rapid loss of the corneal endothelium. Gediz et al [ 9 ] reported that patients who underwent other intraoperative surgical procedures had lower postoperative graft transparency rates and that risky surgical procedures included anterior vitrectomy, goniosynechiolysis, and membranectomy.…”

Section: Discussionmentioning

confidence: 99%

Analysis of risk factors of rapid attenuation of graft endothelium in the early stage after penetrating keratoplasty

Cao

Dong

et al. 2022

PLoS ONE

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This study aimed to analyze the factors of rapid attenuation of graft endothelium in the early stage after penetrating keratoplasty (PKP), with a view to guiding patients with PKP to better long-term outcomes. This study included 226 patients who underwent PKP with follow-up time >1 year at the Qingdao Eye Hospital of Shandong First Medical University from January 2018 to June 2020. Medical records were retrospectively studied, and donor factors, patient factors, and surgical factors were comparatively analyzed to clarify those affecting the rapid decay of graft endothelium after PKP. The median time between excision and death >60 min and patient age >60 years were risk factors for endothelial cell loss (ECL) rate >30% at 1 month postoperatively. However, a higher percentage of patients with donor age ≤60 years and Optisol preservation solution had endothelial cell density (ECD) >2000 cells/mm2 in the graft at postoperative 1 year. A year after the surgery, patients with corneal endothelial decompensation and immune rejection were at risk for ECD < 1000 cells/mm2. The combined operations had a significant effect on the ECL in the early postoperative period. Patients who underwent combined extracapsular cataract extraction or intraocular lens implantation had a significantly higher rate of ECL at postoperative 1 month than other patients, and no significant effect at postoperative 1 year. However, patients without combined operations have a higher probability of maintaining a high level of graft ECD. The graft diameter also affected postoperative ECL. In patients with a larger graft diameter, attenuation of ECD was slower. The ultimate goal of PKP is to maintain graft transparency for extended periods. The use of younger donors, minimizing unnecessary operation in the anterior chamber, and minimizing immune rejection may maintain a greater donor corneal endothelium in the long term.

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“…Therefore, we included 50 articles in our study (see Appendix 3, Supplemental Digital Content 3, http://links.lww.com/ICO/B504). 8,10,19–66…”

Section: Resultsmentioning

confidence: 99%

Long-term Outcomes After Lamellar Endothelial Keratoplasty Compared With Penetrating Keratoplasty for Corneal Endothelial Dysfunction: A Systematic Review

Lemaitre

Tourabaly

Borderie

et al. 2023

Cornea

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The purpose of this study is to evaluate long-term outcomes of endothelial keratoplasty (EK) compared with penetrating keratoplasty (PK) for corneal endothelial dysfunction [Fuchs endothelial corneal dystrophy (FECD) and bullous keratopathy (BK)]. Methods:In this systematic review, we searched PubMed, the Cochrane Library, and Embase up to May 2022 and considered all types of studies addressing our objective. Graft survival at 5, 10, and 15 years was the main outcome.Results: Fifty cohort studies were included. At 5 years, in FECD and BK, graft survival seemed higher after EK than PK. Two comparative studies showed either a higher 5-year graft survival after EK than PK or no significant differences. Including noncomparative studies, in FECD, the 5-year graft survival ranged from 0.

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The Effect of Donor- and Recipient-Related Factors on Corneal Graft Survival in Penetrating Keratoplasty

Cited by 7 publications

References 19 publications

Risk Factors for Corneal Graft Rejection after Penetrating Keratoplasty for Keratoconus

Risk Factors for Corneal Graft Rejection after Penetrating Keratoplasty for Keratoconus

Analysis of risk factors of rapid attenuation of graft endothelium in the early stage after penetrating keratoplasty

Long-term Outcomes After Lamellar Endothelial Keratoplasty Compared With Penetrating Keratoplasty for Corneal Endothelial Dysfunction: A Systematic Review

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