Primary Corneal Graft Failure

Management of Intracorneal Epithelial Cysts With Ethanol Irrigation and Cyst Wall Excision

“…7,13 Recurrence of the cyst may be noted after penetrating keratoplasty and the cyst may appear in the AC, which may lead to pupillary block. 12 Extension of the cyst to the sclera may cause anterior chamber collapse. 13 Excision of the anterior cyst wall combined with cytodestructive treatment of the cyst bed has been associated with a decreased rate of cyst recurrence.…”

Donor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes

“…The notes for information pertaining to indications for DSAEK surgery, patient demographics, and surgical details were reviewed. Donor details were obtained from the Singapore Eye Bank database, including information such as the age of the donor, cause of donor death, death to corneal harvesting time, donor storage time (procurement to transplantation), and distribution distance of tissue (donors were obtained either locally, or from international eye banks based in the USA) 1. Donor and surgical risk factors with patients in the database that had undergone successful DSAEK were compared as the control group.…”

“…Primary graft failure (PGF) refers to failure of the graft to clear after surgery, with persistent graft edema relating to endothelial damage or dysfunction 1. There are no clearly defined risk factors in the majority of cases, but postulated etiologies which have been associated with PGF in penetrating keratoplasty (PK) include donor factors such as trauma as a cause of donor death, donor age > 70 years, prolonged death to preservation time or prolonged donor storage time,2 endothelial damage during donor retrieval or storage,3 and surgical factors relating to surgical technique and surgical trauma 4…”

“…Recent reports have suggested that increased donor endothelial cell loss occurs during automated donor lamellar dissection and donor unfolding in the anterior chamber 6. While PGF following PK is uncommon (reported incidence = 2.1%),1 it is the third most common reported complication following DSAEK (mean rate = 5.0%; range 0%–29%) 7. This is further supported by recent reports of higher endothelial cell loss at 6 months and 1 year after DSAEK, as compared with PK, which is related to more donor tissue manipulation in DSAEK 8,9…”

Eficácia na utilização de córneas no transplante penetrante

“…Mesmo não sendo observados casos de falência primária neste estudo, não se pode afirmar que resultados semelhantes seriam encontrados utilizando-se amostra maior, já uma vez que a incidência de falência primária é, geralmente, menor que 5% (6) . Como existem meios de preservação diferentes, com tempos de conservação variados, a escolha do meio deve ser com base, principalmente, no tempo de espera entre a preparação das córneas e a realização do transplante.…”