Several factors involved in success of repeat corneal grafts

A study featured in Ophthalmology has confirmed there are several factors involved in the success of repeat penetrating corneal transplantation for keratoconus patients. These factors include duration of success of initial graft, age of patient, location of surgery and post-op rejection and corneal neovascularization.

A large cohort investigation led by Dr Keryn A. Williams, Department of Ophthalmology, Flinders Medical Centre, Bedford Park, Australia, included 229 regrafts from a national register of corneal grafts. The study involved 177 eyes of 173 patients and regrafts that had been performed more than once in 16 eyes. The main outcome measure was graft survival- analysed using Kaplan-Meier plots and Cox proportional hazards regression.

It was found that graft survival was significantly worse for second and third grafts compared to the first keratoconus graft. Kaplan-Meier survival plots were 88%, 69% and 46% at 1, 5 and 15 years postgrafting for seconds grafts, respectively. For the third grafts the Meier survival plots were 65%, 49% and 33% at 1, 5 and 15 years postgrafting, respectively.

The risk factors linked to graft failure of repeat grafts included the surgery location, failure of the previous graft within 10 years of surgery, rejection episodes and corneal neovascularization postoperatively.