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Comparison of rejection rates after DALK depending on whether the donor endothelium had been removed or preserved

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First Author: J.Kriman-Nunez UK

Co Author(s):    L. De Benito-Llopis   J. Fajardo-Sanchez                 

Abstract Details

Purpose:

To evaluate rejection rates in patients undergoing Deep Anterior Lamellar Keratoplasty (DALK). To compare rejection rates between DALK performed using grafts in which the donor endothelium had been preserved (endothelium-on) versus grafts in which the endothelium had been removed (endothelium-off). To describe whether patients were using steroids at the time of their rejection episode.

Setting:

Moorfields Eye Hospital NHS Foundation Trust, London, UK

Methods:

Retrospective consecutive interventional study. We reviewed the notes of all the DALKs performed in our hospital between June2016 and July2018. From those, we only included those with 1-year follow-up and with information on whether the donor endothelium had been removed or preserved. We excluded superficial anterior keratoplasty, DALKs converted to penetrating keratoplasty, and therapeutic grafts for active infection. We compared the rejection rates up to one year after the surgery between both groups(endothelium on versus endothelium off). We also studied if there was a difference in the use of steroids at the time of the rejection episodes in both groups.

Results:

126 eyes from 120 patients met the inclusion criteria. Thirty-one DALKs were performed with endothelium-on, and 95 endothelium-off. The number of rejected grafts were 3 (9.6%) and 13 (13.6%) respectively (p=0.56). When analysing both groups together, there was a total rejection rate of 12.69 % after one year follow up. Just 3 of these rejected cases were not using steroid drops at the time of the rejection episode, one in the endothelium-on and two in the endothelium-off group. Of these, only one required re-operation. The rest demonstrated no significant sequelae.

Conclusions:

In our series, rejection rates after DALK did not seem to be affected by donor endothelium status.

Financial Disclosure:

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