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Session Title: Cornea surgical I
Session Date/Time: Tuesday 08/10/2013 | 08:00-10:30
Paper Time: 08:54
Venue: Forum (Ground Floor)
First Author: : D.Mitry UK
Co Author(s): : M. Bhogal B. Allan
To report the long term survival, the risk factors for graft failure and the final visual outcome of DSAEK after a failed PKP
A multi-centre retrospective case series comprising 246 consecutive grafts from 6 tertiary referral centres worldwide
A KaplanMeier analysis was used to determine the cumulative probability of graft survival and a Cox proportional multivariate regression model was fitted to examine for prognostic factors associated with DSAEK failure after PKP.
The mean(SD) recipient age was 63.2(16.6) years and the median follow-up period was 17 months (range: 8 days-72 months). In total, 53% were male, 74.8% had a posterior chamber intra-ocular lens at the time of surgery and 19% had more than one failed PKP prior to DSAEK. At final follow-up, 19.1%(47/246) of grafts had failed. The cumulative probability of DSAEK survival after a failed PKP graft in the entire cohort was 0.89, 0.74 and 0.47 at 1 year, 3 years and 5 years respectively. Significant independent risk factors for graft failure on multivariate analysis were age group, cause of PKP failure, centre and previous glaucoma surgery. At final follow-up, 64.6% of grafts achieved ? 6/18 (20/60) corrected distance visual acuity.
DSAEK after failed PKP carries a good visual outcome and a comparable if not better survival rate to repeat PKP. Young age, rejection, surgical centre and previous glaucoma shunt surgery are associated with a higher risk of subsequent graft failure.
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