Donor Failure After Corneal Transplantation Surgery

Buxton, Jorge N.; Seedor, John A.; Perry, Henry D.; Eagle, Ralph C.; Pecego, Jose A.

doi:10.1097/00003226-198802000-00001

Cited by 21 publications

(9 citation statements)

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“…Grafts with low endothelial cell counts and disrupted integrity are expected to have less resistance to surgical trauma, postoperative inflammation, deficient wound healing, rejection, aging, etc. (12)(13)(14)(15)(16)(17)(19)(20)(21)(22)(23)(24)(25)(26)(27). Early endothelial cell loss following penetrating keratoplasty is attributable to poor quality of buttons (15,27), recipient age (15), donor age (15,27,28), inappropriate preservative media and technique (10), prolonged duration from death to enucleation and preservation time (12), and operative technique and procedure (26).…”

Section: Discussionmentioning

confidence: 99%

“…Modern techniques improve preoperative assessment of the quality of donor buttons and enhance the success of surgery (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Well-preserved corneal buttons can also better tolerate intraoperative and postoperative insults; therefore, modern preservative media can decrease the rate of primary graft failure (12)(13)(14)(15)(16)(17). Primary graft failure is rare in western countries with the advance of new corneal preservative media (16)(17); however, it remains a major concern in many other areas of the world.…”

Section: Introductionmentioning

confidence: 99%

“…Well-preserved corneal buttons can also better tolerate intraoperative and postoperative insults; therefore, modern preservative media can decrease the rate of primary graft failure (12)(13)(14)(15)(16)(17). Primary graft failure is rare in western countries with the advance of new corneal preservative media (16)(17); however, it remains a major concern in many other areas of the world. Because corneal donation in Taiwan is rare due to religious reasons, most of the corneal buttons for keratoplasty are obtained through importation from other countries, especially from the United States.…”

Section: Introductionmentioning

confidence: 99%

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Effect of shaking on corneal endothelial preservation

Wang

1997

Current Eye Research

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of shaking on corneal endothelial preservation

Wang

1997

Current Eye Research

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“…Complication of PKP include graft rejection or failure, graft dehiscence, infection, flat anterior chamber, pupillary block, synechial angle closure, aqueous misdirection, hyphema, cataract, retinal detachment, choroidal effusion, suprachoroidal hemorrhage, and endophthalmitis [17][18][19][20][21][22][23][24][25][26][27]. One of the more common complications after PKP is the development of glaucoma, which may occur either early or late postoperatively [28][29][30][31][32][33][34][35].…”

mentioning

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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“…Buxton et al reported five cases of graft failure within 24 hours of PK that were histopathologically consistent with Fuchs dystrophy [4]. In these cases, a combination of poor quality donor endothelium and intraoperative trauma were thought to be responsible.…”

Section: Discussionmentioning

confidence: 99%

Guttae in the donor after Descemet-stripping automated endothelial keratoplasty

Lee

Virdi

Hammersmith

et al. 2010

Graefes Arch Clin Exp Ophthalmol

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Guttae may occur in the donor cornea after DSAEK, as previously seen after PK. Potential causes include problems with tissue preparation and grading, tissue misidentification, or surgical manipulation. Methods of elucidating whether there is an underlying predisposition to guttae formation in certain grafts, continued vigilance to ensure the highest-quality donor tissue, and meticulous surgical technique will be necessary as the use of DSAEK continues to grow.

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Donor Failure After Corneal Transplantation Surgery

Cited by 21 publications

References 0 publications

Effect of shaking on corneal endothelial preservation

Effect of shaking on corneal endothelial preservation

Graft failure: III. Glaucoma escalation after penetrating keratoplasty

Guttae in the donor after Descemet-stripping automated endothelial keratoplasty

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