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Patient Factors Identified Affecting Corneal Graft Failure

Aphakic/pseudophakic corneal edema diagnosis, prior glaucoma surgery increases graft failure rate

THURSDAY, June 4 (HealthDay News) -- Corneal grafts are more apt to fail in patients with a diagnosis of aphakic or pseudophakic corneal edema or in patients who have had prior glaucoma surgery and treatment, according to a study in the June issue of Ophthalmology.

Alan Sugar, M.D., of the University of Michigan in Ann Arbor, and colleagues randomly assigned donor corneas to be used in corneal transplant in 1,090 subjects for a moderate-risk condition, mainly Fuchs' dystrophy or pseudophakic corneal edema. Surgeons were masked to information about the donor cornea and performed the procedure and delivered postoperative care in the usual way. Subjects were followed for five years to check for graft failure, which was defined as required regraft or cloudy cornea that impaired vision for three or more months. Patient baseline factors were evaluated for their association with graft failure.

Researchers found that a pre-surgery diagnosis of pseudophakic or aphakic corneal edema led to an almost four-fold increase in graft failure compared with Fuchs' dystrophy (27 versus 7 percent). Previous glaucoma surgery and use of glaucoma medication before the corneal surgery also increased the rate of graft failure. Age, gender, graft size, smoking and diabetes were not associated with graft failure.

"The risk of graft failure is significantly increased in eyes with pseudophakic or aphakic corneal edema compared with Fuchs' dystrophy, independent of lens status, and in eyes with a history of glaucoma," the authors conclude.

One study author reported receiving financial support from Bausch & Lomb Inc., Katena Products Inc., ViroMed Laboratories Inc., and Konan Medical Corp. The study was supported by these companies.

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