A CASE REPORT OF PRIMARY CORNEAL GRAFT FAILURE FOLLOWING PENETRATING KERATOPLASTY

Purpose: To report indications and outcomes of combined pars plana vitrectomy and penetrating keratoplasty (PPV-PKP). Methods: A review of all patients who underwent PPV-PKP at the Illinois Eye and Ear Infirmary from January 1, 2001 to May 31, 2013, was performed. Ninety eyes of 90 patients were identified. Survival analysis was utilized to assess differences in retinal detachment (RD) and corneal graft failure rates among groups based on clinical and surgical variables. Results: Seventy-nine eyes met the inclusion criteria. Most common indications for vitrectomy and corneal transplantation were RD (65%) and corneal decompensation (43%), respectively. The preoperative and final visual acuity (VA) logarithm of the minimum angle of resolution values were 2.7 (0.31) and 2.5 (0.67) (hand motions; mean [SD]; P = .02); 15% of eyes were ≥20/400 and 15% gained ≥2 lines of vision following surgery. Corneal graft failure occurred in 51% (40 eyes), recurrent RD in 28% (22 eyes), and hypotony in 25% (20 eyes). Silicone oil endotamponade was associated with postoperative RD ( P = .045), and previous ocular trauma was associated with postoperative corneal graft failure ( P = .023). Conclusion: Combined PPV-PKP surgery was likely to achieve stabilization of VA, with a minority of eyes achieving modest gains in VA.

Download Full-text

Graft Survival after Penetrating Keratoplasty in Cases of Trabeculectomy versus Ahmed Valve Implant

Journal of Ophthalmology ◽

10.1155/2018/9034964 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Abdelhamid Elhofi ◽

Hany Ahmed Helaly

Keyword(s):

Mitomycin C ◽

Graft Survival ◽

Graft Failure ◽

Penetrating Keratoplasty ◽

Anterior Segment ◽

Group Versus ◽

Corneal Graft ◽

Ahmed Glaucoma Valve ◽

Significant Difference ◽

Corneal Graft Failure

Purpose. To compare the corneal graft survival rates after penetrating keratoplasty (PKP) in cases of post-PKP glaucoma managed by either trabeculectomy with mitomycin C or Ahmed glaucoma valve (AGV). Methods. This study was a retrospective interventional comparative study that included 40 eyes of 40 patients. The included patients had undergone previous PKP for anterior segment reconstruction after microbial or fungal keratitis, chemical burns, trauma, or perforated corneal ulcer. Post-PKP glaucoma was managed surgically by either trabeculectomy with mitomycin C (group 1) or Ahmed glaucoma valve (group 2). Results. The first group n=20 had undergone trabeculectomy with MMC, and the second group n=20 had undergone AGV implantation. Regarding BCVA, there was no statistically significant difference between the 2 groups. Mean IOP was significantly lower in the AGV group at 6 months, 12 months, and 24 months p=0.001. Mean IOP at 24 months dropped significantly from preglaucoma surgery levels in both groups p=0.001. Rejection episodes occurred in 2 eyes (10%) of the trabeculectomy group versus 8 eyes (40%) in the AGV group p=0.028. In the trabeculectomy group, corneal graft failure occurred in 1 (5%), 3 (15%), and 6 (30%) eyes at 6 months, 12 months, and 24 months, respectively. In the AGV group, corneal graft failure occurred in 2 (10%), 5 (25%), and 10 (50%) eyes at 6 months, 12 months, and 24 months, respectively. The mean time to failure in the trabeculectomy group was 12.33 ± 5.60 months versus 11.90 ± 5.70 months in the AGV group p=0.027. Conclusion. Managing postpenetrating keratoplasty glaucoma could be bothersome especially in complex cases. Ahmed glaucoma valve implant controls the intraocular pressure more effectively than trabeculectomy with mitomycin C. However, Ahmed glaucoma valve can result in higher rates of corneal graft failure in a shorter duration of time. This trial is registered with PACTR201712002861391 on 21 Dec 2017.

Download Full-text

Summing up Present Knowledge and Problems of Corneal Graft Failure

Ciba Foundation Symposium 15 - Corneal Graft Failure - Novartis Foundation Symposia ◽

10.1002/9780470719985.ch20 ◽

2008 ◽

pp. 349-354 ◽

Cited By ~ 2

Author(s):

Barrie R. Jones

Keyword(s):

Graft Failure ◽

Present Knowledge ◽

Corneal Graft ◽

Corneal Graft Failure

Download Full-text

Effectiveness of Histocompatibility Matching in High-Risk Corneal Transplantation

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0001 ◽

2020 ◽

pp. 1-8

Author(s):

Alan D. Penman ◽

Kimberly W. Crowder ◽

William M. Watkins

Keyword(s):

High Risk ◽

Graft Failure ◽

Corneal Transplantation ◽

Corneal Graft ◽

Hla Dr ◽

Risk Patients ◽

Graft Success ◽

Group Matching ◽

Corneal Graft Failure

The Collaborative Cornea Transplant Studies (CCTS) comprised two randomized, double-masked, clinical trials, the Antigen Matching Study (AMS) and the Crossmatch Study (CS), designed to determine whether matching HLA-A, -B, and/or HLA-DR antigens, donor-recipient crossmatching, or ABO compatibility reduced the risk of corneal allograft rejection and failure in high-risk patients. The studies showed that for patients needing a corneal graft with uncompromised immune systems and at high risk for corneal graft rejection: (1) neither HLA-A, -B, nor HLA-DR antigen matching substantially reduces the likelihood of corneal graft failure; (2) a positive donor-recipient crossmatch does not dramatically increase the risk of corneal graft failure; and (3) ABO blood group matching may be effective in reducing the risk of graft failure. Intensive steroid therapy after transplantation, frequent follow-up, medication and follow-up compliance, and patient education appear to play a significant role in corneal graft success.

Download Full-text