GRAFT REJECTION AND GRAFT FAILURE AFTER ANTERIOR LAMELLAR VERSUS PENETRATING KERATOPLASTY

2011 ◽  
Vol 12 (4) ◽  
pp. e1-e2
Author(s):  
Michael Banitt
Keyword(s):  
Graft Rejection ◽  
Graft Failure ◽  
Penetrating Keratoplasty

Survey of Rejection Prophylaxis Following Suture Removal in Penetrating Keratoplasty in Germany

2021 ◽  
Author(s):  
Sonja Heinzelmann ◽  
Daniel Böhringer ◽  
Philip Christian Maier ◽  
Berthold Seitz ◽  
Claus Cursiefen ◽  
...  
Keyword(s):  
Graft Rejection ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Treatment Strategies ◽  
Cost Benefit ◽  
Topical Steroids ◽  
Evidence Based ◽  
Systematic Analysis ◽  
Open Questions ◽  
The Face

Abstract Background Penetrating keratoplasty (PK) gets more and more reserved to cases of increasing complexity. In such cases, ocular comorbidities may limit graft survival following PK. A major cause for graft failure is endothelial graft rejection. Suture removal is a known risk factor for graft rejection. Nevertheless, there is no evidence-based regimen for rejection prophylaxis following suture removal. Therefore, a survey of rejection prophylaxis was conducted at 7 German keratoplasty centres. Objective The aim of the study was documentation of the variability of medicinal aftercare following suture removal in Germany. Methods Seven German keratoplasty centres with the highest numbers for PK were selected. The centres were sent a survey consisting of half-open questions. The centres performed a mean of 140 PK in 2018. The return rate was 100%. The findings were tabulated. Results All centres perform a double-running cross-stitch suture for standard PK, as well as a treatment for rejection prophylaxis with topical steroids after suture removal. There are differences in intensity (1 – 5 times daily) and tapering (2 – 20 weeks) of the topical steroids following suture removal. Two centres additionally use systemic steroids for a few days. Discussion Rejection prophylaxis following PK is currently poorly standardised and not evidence-based. All included centres perform medical aftercare following suture removal. It is assumed that different treatment strategies show different cost-benefit ratios. In the face of the diversity, a systematic analysis is required to develop an optimised regimen for all patients.

Systematic review and meta-analysis of femtosecond laser–enabled keratoplasty versus conventional penetrating keratoplasty

2020 ◽  
pp. 112067212091448
Author(s):  
Yang Liu ◽  
Xiaojun Li ◽  
Wenjie Li ◽  
Xudong Jiu ◽  
Mannan Tian
Keyword(s):  
Femtosecond Laser ◽  
Graft Rejection ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Mean Difference ◽  
Spherical Equivalent ◽  
Corrected Visual Acuity ◽  
Standard Mean Difference ◽  
Topographic Astigmatism ◽  
Best Corrected Visual Acuity

Purpose: The aim of this meta-analysis is to compare femtosecond laser–enabled keratoplasty with conventional penetrating keratoplasty regarding postoperative astigmatism, visual functions, graft rejection, graft failure, and complications. Methods: Eligible studies were retrieved from five mainstream electronic databases, including PubMed, Embase, Ovid MEDLINE, Cochrane Library, and ClinicalTrial.gov. Postoperative topographic astigmatism was set as the primary outcome, and best-corrected visual acuity, spherical equivalent, endothelial cell density, graft rejection, graft failure, and complications were chosen as the secondary outcomes. Standard mean difference and risk ratio were the size effects for continuous data and binomial data, respectively. The data were pooled through either the random-effects model or the fixed-effects model based on data heterogeneity. Moreover, subgroup analyses were conducted when the heterogeneity occurred distinctly (I2 > 50%). Results: A total of seven comparative studies were included. The pooled standard mean difference (−0.32, 95% confidence interval: −0.74 to 0.10) showed that femtosecond laser–enabled keratoplasty was not superior over conventional penetrating keratoplasty to decrease postoperative topographic astigmatism (p = 0.14). However, best-corrected visual acuity after femtosecond laser–enabled keratoplasty was significantly better than that after conventional penetrating keratoplasty (p = 0.00, standard mean difference: −0.23, 95% confidence interval: −0.37 to −0.10). Furthermore, endothelial cell density after femtosecond laser–enabled keratoplasty was preserved significantly better (p = 0.03, standard mean difference: 0.63, 95% confidence interval: 0.07–1.20). Moreover, spherical equivalent, graft rejection, graft failure, and complications represented no distinct differences between femtosecond laser–enabled keratoplasty and conventional penetrating keratoplasty (p > 0.05). Conclusion: Femtosecond laser–enabled keratoplasty may not be superior over conventional penetrating keratoplasty in decreasing postoperative topographic astigmatism, but might have advantages to achieve best-corrected visual acuity and endothelial cell density preservation. In addition, the two techniques seem to be comparable regarding spherical equivalent, graft rejection/failure, and complications.

scholarly journals Graft Rejection Rate and Graft Failure Rate of Penetrating Keratoplasty (PKP) vs Lamellar Procedures: A Systematic Review

PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0119934 ◽  
Author(s):  
Zarique Z. Akanda ◽  
Abdul Naeem ◽  
Elizabeth Russell ◽  
Jillian Belrose ◽  
Francie F. Si ◽  
...  
Keyword(s):  
Systematic Review ◽  
Failure Rate ◽  
Graft Rejection ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Rejection Rate

Graft Rejection and Graft Failure After Anterior Lamellar Versus Penetrating Keratoplasty

2011 ◽  
Vol 152 (6) ◽  
pp. 1081-1082
Author(s):  
Balasubramanian Ramasamy ◽  
Adrian Tey ◽  
Stephen B. Kaye
Keyword(s):  
Graft Rejection ◽  
Graft Failure ◽  
Penetrating Keratoplasty

Graft Rejection and Graft Failure After Anterior Lamellar Versus Penetrating Keratoplasty

2011 ◽  
Vol 151 (6) ◽  
pp. 1024-1029.e1 ◽  
Author(s):  
Vincent M. Borderie ◽  
Emmanuel Guilbert ◽  
Olivier Touzeau ◽  
Laurent Laroche
Keyword(s):  
Graft Rejection ◽  
Graft Failure ◽  
Penetrating Keratoplasty

scholarly journals Midterm outcomes of penetrating keratoplasty following allogeneic cultivated limbal epithelial transplantation in patients with bilateral limbal stem cell deficiency

2021 ◽  
Vol 14 (11) ◽  
pp. 1690-1699
Author(s):  
Jun-Fa Xue ◽  
◽  
Ya-Ni Wang ◽  
Chen Chen ◽  
Ru-Fei Yang ◽  
...  
Keyword(s):  
Stem Cell ◽  
Graft Survival ◽  
Graft Rejection ◽  
Ocular Surface ◽  
Penetrating Keratoplasty ◽  
Limbal Stem Cell Deficiency ◽  
Time Interval ◽  
Case Series Study ◽  
Limbal Stem Cell ◽  
Cultivated Limbal Epithelial Transplantation

AIM: To evaluate the midterm outcomes of penetrating keratoplasty (PK) following allogeneic cultivated limbal epithelial transplantation (CLET) for bilateral total limbal stem cell deficiency (LSCD). METHODS: Ten patients (10 eyes) with bilateral LSCD were enrolled in this prospective noncomparative case series study. Each participant underwent PK approximately 6mo after a CLET. Topical tacrolimus, topical and systemic steroids, and oral ciclosporin were administered postoperatively. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), ocular surface grading scores (OSS), corneal graft epithelial rehabilitation, persistent epithelial defect (PED), immunological rejection, and graft survival rate were assessed. RESULTS: The time interval between PK and allogeneic CLET was 6.90±1.29 (6-10)mo. BCVA improved from 2.46±0.32 logMAR preoperatively to 0.77±0.55 logMAR post-PK (P<0.001). Kaplan-Meier analysis of mean graft survival revealed graft survival rates of 100% at 12 and 24mo and 80.0% at 36mo. PEDs appeared in 5 eyes at different periods post-PK, and graft rejection occurred in 4 eyes. The total OSS decreased from 12.4±4.4 before allogeneic CLET to 1.4±1.51 after PK. CONCLUSION: A sequential therapy design of PK following allogeneic CLET can maintain a stable ocular surface with improved BCVA despite the relatively high graft rejection rate.

scholarly journals Pediatric penetrating keratoplasty and graft rejection: experience at the Hospital Infantil de México Federico Gómez

2020 ◽  
Vol 77 (1) ◽  
Author(s):  
Karen Velásquez-Monzón ◽  
Mariana C. Navarro-Peña ◽  
Miguel Klünder-Klünder ◽  
Michael Tsatsos ◽  
Marco A. Ramírez-Ortiz
Keyword(s):  
Graft Rejection ◽  
Penetrating Keratoplasty

Efficacy and Safety of Systemic Tacrolimus in High-Risk Penetrating Keratoplasty After Graft Failure With Systemic Cyclosporine

Cornea ◽  
2014 ◽  
Vol 33 (11) ◽  
pp. 1157-1163 ◽  
Author(s):  
Kyoko Yamazoe ◽  
Katsuya Yamazoe ◽  
Takefumi Yamaguchi ◽  
Masahiro Omoto ◽  
Jun Shimazaki
Keyword(s):  
High Risk ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Efficacy And Safety
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