The profile of repeated corneal transplantation

Bersudsky, Valery; Blum-Hareuveni, Tami; Rehany, Uri; Rumelt, Shimon

doi:10.1016/s0161-6420(00)00544-3

Cited by 134 publications

(112 citation statements)

References 15 publications

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“…[17][18][19][20][21] Graft clarity and visual outcome in our study were similar to that of the entire repeated corneal transplanted group and higher than the rate of regraft clarity in eyes complicated by immune graft rejection or glaucoma. 5,9 In conclusion, cataract development after repeated corneal transplantation is a frequent short-and long-term complication. However, cataract surgery, when indicated, does not decrease the overall survival rate of the repeated corneal grafts.…”

Section: Eyementioning

confidence: 94%

“…The definitions of complications such as immune graft rejection and their treatment are described elsewhere. 5,6 Statistical analysis for categorical covariates was performed with w 2 test and two-tailed Po0.05 was considered statistically significant.…”

Section: Methodsmentioning

confidence: 99%

“…The indications for the first transplantation were similar to those reported previously by us for the entire regrafted patients. 5 In total, 10 patients had corneal scar (eight of them due to herpetic keratitis without uveitis), seven had keratoconus, one had Fuchs' corneal dystrophy, and one had perforated ulcer.…”

Section: Data On Cataract Developmentmentioning

confidence: 99%

“…The causes for graft failure in the group that developed cataract were similar to those of the entire regrafted group. 5 Sixteen of the 17 eyes with graft failure after cataract surgery had repeated corneal transplantation. In eight of them (50%) the corneal regraft remained clear, in seven of them the visual acuity improved from HM-20/200 to 20/100-20,/40 and in one, visual acuity remained poor due to cystoid macular oedema.…”

Section: Surgical Management Of the Cataract Graft Clarity And Visumentioning

confidence: 99%

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Development and progression of cataract in patients required repeated corneal transplantation

Rumelt

Blum-Hareuveni

Bersudsky

et al. 2003

Eye

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Purpose To evaluate the incidence of cataract development in patients required repeated corneal transplantations, the types of cataract and the effect of cataract extraction on the corneal regrafts survival. Patients and MethodsThe charts of all the patients that underwent repeated corneal transplantation between 1985 and 1998 were reviewed for the development of cataract after the first or subsequent keratoplasties. In all, 80 patients underwent 122 repeated corneal transplantations, of which six underwent surgery in both eyes. The average follow-up period of all the patients with repeated keratoplasty was 89.5 months from the first keratoplasty.

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Section: Eyementioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Data On Cataract Developmentmentioning

confidence: 99%

Section: Surgical Management Of the Cataract Graft Clarity And Visumentioning

confidence: 99%

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Development and progression of cataract in patients required repeated corneal transplantation

Rumelt

Blum-Hareuveni

Bersudsky

et al. 2003

Eye

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“…41,45,46 While the most common indication for initial PKP in cases with repeat keratoplasty was bullous keratopathy in developed nations, active keratitis and corneal scar were indications in developing nations. Even in the paediatric age group the indications for keratoplasty differ in developing and developed nations (Table 6).…”

Section: Causes Of Corneal Blindnessmentioning

confidence: 99%

The value of corneal transplantation in reducing blindness

Garg

Krishna

Stratis

et al. 2005

Eye

123

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Purpose To analyse the role of keratoplasty in reducing world blindness due to corneal diseases. Methods Review of published literature. We collected and analysed articles published in the English language literature related to the prevalence and causes of blindness in different parts of the world, causes of corneal blindness, and outcome of corneal transplantation for various corneal diseases. Results A total of 80% of the world's blind live in developing countries. Retinal diseases are the most important causes of blindness (40-54%) in established economy nations while cataract (44-60%) and corneal diseases (8-25%) are the most common causes of blindness in countries with less developed economies. Keratitis during childhood, trauma, and keratitis during adulthood resulting in a vascularized corneal scar and adherent leucoma are the most frequent causes of corneal blindness in developing countries. Corneal diseases are responsible for 20% of childhood blindness. Nearly 80% of all corneal blindness is avoidable. The outcome of keratoplasty for vascularized corneal scar and adherent leucoma is unsatisfactory, necessitating repeat surgery in a high proportion of these cases. Other barriers for keratoplasty in these nations are suboptimal eye banking, lack of trained human resources, and infrastructure. Conclusions Since the developing world carries most of the load of corneal blindness and the major causes of corneal blindness are corneal scar and active keratitis, development of corneal transplantation services need a comprehensive approach encompassing medical standards in eye banking, training of cornea specialists and eye banking personnel and exposure of ophthalmologists to care of corneal transplants for better follow-up care. However, concerted efforts should be made to develop and implement prevention strategies since most corneal blindness is preventable.

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Descemet Stripping Automated Endothelial Keratoplasty After Failed Penetrating Keratoplasty

et al. 2014

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IMPORTANCE Descemet stripping automated endothelial keratoplasty (DSAEK) for isolated endothelial dysfunction has become the preferred surgical option for many corneal surgeons. However, there are limited large-scale reports on DSAEK survival and clinical variables affecting the risk of rejection and failure after failed penetrating keratoplasty (PK). OBJECTIVE To report the survival, risk factors for graft rejection and failure, and visual outcome of DSAEK after failed PK. DESIGN, SETTING, AND PARTICIPANTS A multicenter retrospective interventional case series included patients recruited from 6 tertiary referral surgical centers: 3 in the United States, 2 in Europe, and 1 in Asia. A total of 246 consecutive eyes (246 patients) that underwent DSAEK after failed PK, with a minimum follow-up period of 1 month, was included. Data comprising demographic details, preoperative and postoperative risk factors, time to rejection, time to failure, and corrected distance visual acuity were collected. MAIN OUTCOMES AND MEASURES Cumulative probability of graft survival, hazard ratio estimates for survival, and corrected distance visual acuity were determined. RESULTS The mean (SD) recipient age was 63.2 (16.6) years and the median follow-up period was 17 months (interquartile range, 6-30 months). One-third of the grafts (n = 82) had follow-up data for more than 2 years; 18.3% had more than 1 failed PK before DSAEK. In total, 19.1% (47 of 246) of DSAEK grafts failed. The cumulative probability of DSAEK survival after a failed PK was 0.89 (95% CI, 0.84-0.92), 0.74 (95% CI, 0.64-0.81), and 0.47 (95% CI, 0.29-0.61) at 1 year, 3 years, and 5 years, respectively. Based on multivariate analysis, significant preoperative risk factors for failure were young recipient age (hazard ratio [HR], 5.18 [95% CI, 1.57-17.18]), previous tube filtration surgery (HR, 5.23 [95% CI, 1.47-7.33]), and rejection episodes before PK failure (HR, 3.28 [95% CI, 1.47-7.33]); single-surgeon centers had a protective effect. Any rejection episode prior to PK failure was a significant predictor of post-DSAEK rejection, which in turn was a significant predictor of DSAEK failure. After a median follow-up of 17 months, 33.3% of the grafts achieved 0.3 or greater logMAR (20/40) corrected distance visual acuity. CONCLUSIONS AND RELEVANCE Descemet stripping automated endothelial keratoplasty after failed PK combines greater wound stability and reduced suture-related complications, with visual outcomes and graft survival rates comparable to those of a second PK.

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The profile of repeated corneal transplantation

Cited by 134 publications

References 15 publications

Development and progression of cataract in patients required repeated corneal transplantation

Development and progression of cataract in patients required repeated corneal transplantation

The value of corneal transplantation in reducing blindness

Descemet Stripping Automated Endothelial Keratoplasty After Failed Penetrating Keratoplasty

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