Corneal Transplant Rejection
Conditions
Keywords
Cornea / surgery, Corneal Transplantation* / adverse effects, Corneal Transplantation* / methods, Graft Rejection / prevention & control, Humans
Brief summary
Keratoplasty is one of the most common grafts and penetrating keratoplasty is still the technique most used in the world, ahead of lamellar grafts, and is estimated to represent 70% of the total. Graft rejection is still the main cause of failure of this type of surgery, to the extent that nearly a third of all patients will in some way be affected by rejection in due course. Numerous risk factors for rejection have been identified, whether related to the donor, the recipient, or the surgical procedure itself. In addition, many of the studies performed have used univariate analysis only, and yet there is a strong case for multivariate analysis, given the wide range of factors that need to be examined. This study seeks to analyze the rejection rates and the survival of penetrating keratoplasty for a group of patients from Montpellier Hospital (France).
Interventions
None listed
Sponsors
University Hospital, Montpellier
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
-keratoplasty performed in the ophthalmology department of the CHRU of Montpellier between 15/06/2005 and 18/09/2018
Exclusion criteria
* a non-optical graft (tectonic and analgesic graft) * lamellar graft (DALK (Deep Anterior Lamellar Keratoplasty) and DSAEK (Descemet Stripping Automated Endothelial Keratoplasty)) * Silica gel re-dried cornea, duplicates (we included each patient only once per eye) * medical record missing from the archives.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| graft rejection | 1 day | The main criterion studied is the fact that rejection had occurred, defined by the appearance of a rejection line, whether epithelial or endothelial (Khodadoust line), subepithelial infiltrates, or an anterior chamber inflammatory reaction (Tyndall effect, retro corneal precipitates and Descemet folds) with corneal edema in a previously clear graft. Opaque grafts with no clear period in the 2 weeks after grafting were not considered as rejections, but rather as straightforward graft failures. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| irreversible graft rejection | 1 day | The other criteria studied is irreversible graft rejection, defined as the persistence of a central corneal edema for 3 months despite treatment, and graft failure, defined as a second keratoplasty, or the persistence of a central corneal edema persisting for more than 3 months, whatever the cause (rejection, corneal endothelial cell failure, other). |
Countries
France
Outcome results
None listed