CORNEAL GRAFT SURVIVAL ANALYSIS AFTER PENETRATING KERATOPLASTY IN A RETROSPECTIVE COHORT STUDY

Published 2022 - 26th ESCRS Winter Meeting

Reference: FP105 | Type: Abstracts | DOI: 10.82333/6d5c-8g29

Authors: Sergey Sakhnov ¹ , Victoria Myasnikova* ² , Alexey Klokov ³ , Ruset Shu ² , Tamriko Zakaraiia ²

¹Department of Administration,S Fyodorov Eye Microsurgery Federal State Institution,Krasnodar,Russian Federation, ²Department of Science,S Fyodorov Eye Microsurgery Federal State Institution,Krasnodar,Russian Federation, ³Department of Surgery,S Fyodorov Eye Microsurgery Federal State Institution,Krasnodar,Russian Federation

Purpose

Although corneal transplantation techniques have become increasingly sophisticated, a review of publications on this topic shows that immunological rejection reactions remain relevant. The pathogenesis of graft disease is complex, associated with many risk factors related to the recipient, donor, surgical technique, and perioperative therapy. The aim of this work was to evaluate the long-term results of penetrating keratoplasty in patients of different risk groups and to identify risk factors for corneal graft disease.

Setting

Retrospective cohort study conducted at the S Fyodorov Eye Microsurgery Federal StateInstitution - Krasnodar, Russia.

Methods

Data of 582 patients after corneal transplantation performed in the period since 2011 to 2019 for keratoconus (41%), as well for corneal leucorrhoea and dystrophies (59%), aggravated by concomitant pathology - the so-called high-risk keratoplasty (HRK) were analyzed in a retrospective cohort study. We estimated the functional results and incidence of graft disease (GD). The calculation of the t-criterion; cross-tabulation method; Kaplan-Meier survival analysis and multivariate analysis were applied.

Results

As a result of penetrating keratoplasty, the BCVA (best corrected visual acuity) in patients with keratoconus increased by 20%; in patients with HRK – by 8%. In the general group the graft survival rate was 72%, while the 8-year successful graft engraftment in patients with keratoconus comprised 91%, with HRK – 60%. A significant relationship of the GD development with preoperative diagnosis and rekeratoplasty was determined. The risk of GD incidence was minimal in patients under 30 years of age and maximum in patients aged from 50 to 70 years. Survival rates for corneal transplants were better in men than in women. Multiple regression analysis showed a significant correlation with surgical outcome of primary diagnosis, rekeratoplasty and patient age (p≤0.05).

Conclusion

Penetrating keratoplasty in patients with keratoconus provides a good functional result with a minimal risk of graft disease development. With penetrating keratoplasty in high-risk patients, the effectiveness of surgical interventions is significantly lower (by ~ 30%). Survival analysis showed the highest statistically significant correlation of graft disease occurrence with preoperative diagnosis and rekeratoplasty. Graft survival was significantly higher in the case of uncomplicated keratoplasty on the contralateral eye in the history.