Recipient Diagnosis Associated With Corneal Graft Failure

But length of corneal preservation is not a risk factor for graft failure 20 years after keratoplasty

FRIDAY, April 16 (HealthDay News) -- Recipient diagnosis is a risk factor for graft failure after penetrating keratoplasty, though length of corneal preservation is not associated with either graft failure or late endothelial failure (LEF), according to a study in the April issue of the Archives of Ophthalmology.

Sanjay V. Patel, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues conducted a prospective observational study of 500 consecutive penetrating keratoplasty procedures done by the same surgeon. They excluded eyes undergoing second grafts and fellow eyes of bilateral cases. At the 20-year mark, they examined 41 grafts.

The researchers found that corneal preservation method and length of donor preservation were not associated with graft failure or LEF. The graft recipients' pre-transplant diagnosis, however, was a factor; those with a pre-transplant diagnosis of endothelial dysfunction had a higher risk of graft failure and LEF than those with a diagnosis of keratoconus. In addition, endothelial cell density and higher endothelial cell loss at two months were associated with an increased risk of LEF for an endothelial dysfunction diagnosis but not a keratoconus diagnosis.

"Although the Cornea Donor Study will definitively answer the question about donor age and graft failure, the effect of preservation time on graft failure warrants a randomized, prospective study to confirm our findings and support extended preservation as a method of expanding the donor pool," the authors write.

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