KLAL significantly affected by adverse events

Keratolimbal allograft (KLAL) transplantation is affected by adverse events including immunologic rejections, chronic ocular surface exposure and graft-related complications, according to a study featured in Cornea.

A retrospective, observational case series, led by Dr A. Baradaran-Rafii, Ophthalmic Research Centre, Labbafinejad Medical Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran, included assessing the medical charts of 45 patients with at least six months of follow-up. Main outcome measures were postoperative complications including graft thickness, position and alignment and immunologic rejection.

A total of 66 KLALs were performed on 45 eyes and primary failure occurred in five eyes due to ocular surface exposure and severe dry eyes. Four eyes experienced misalignments, four eyes presented with buttonhole, a further four eyes had inner-edge tear, two had inadvertent limbal trephination and two had thick KLAL.

After KLAL, eight eyes presented with regional thinning of the graft due to exposure, regional ischemia and after epithelial rejection. There were 16 cases of acute rejection in eight eyes, whereas chronic rejection was seen in 24 eyes.

At the final follow-up 12 eyes had failed because of recurrent acute rejection, chronic rejection, refractory herpetic keratitis, exposure and refractory papillomavirus keratitis. The most significant complications were identified as immunologic rejections, chronic ocular surface exposure and graft-related complications.

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