Posters

Risk factors for graft failure and long-term survival after corneal transplantation at the University Clinical Hospital of Valladolid: analysis of 254 procedures

Poster Details

First Author: L.Pareja Arico SPAIN

Co Author(s): J. Herreras Cantalapiedra   D. Galarreta Mira   F. Valentín Bravo              

Abstract Details

Purpose:

To define the main risk factors associated with graft failure and evaluate the functionality and long-term survival in patients undergoing corneal transplantation

Setting:

Universitary Clinical Hospital of Valladolid.

Methods:

Through the elaboration of a retrospective cross-sectional study, 254 keratoplasties performed between 2012 to 2017 were evaluated (PK 48,4%, DMEK 24,8%, DALK 20,1%, DSAEK 4,3% and Boston Keratoprosthesis (2.4%). A T-test of paired samples compared the preoperative and postoperative pinhole corrected visual acuity of the operated patients. Once the potential risk factors had been identified; an univariate analysis was applied using chi-squared tests to detect possible associations between the analysed covariates and the final graft state. The long-term survival of the transplants was performed by using the Kaplan Meier estimator in the form of survival tables.

Results:

Pinhole corrected visual acuity improved from 0.66 LogMAR before surgery to 0.38 LogMAR after surgery (p < 0.0001). Among the characteristics analysed in the univariate analysis, the previous vascularization of the recipient eye, the diagnosis by which the procedure is indicated and the fact of performing a combined surgery were statistically significant. Accumulated survival in the different types of keratoplasty at the end of the follow-up was 69.1% for penetrating keratoplasty, 93.7% for the DMEK 66.7% for the DALK, 36.4% for the DSAEK and 66.7% for the K-PRO (Logrank test < 0.0001)

Conclusions:

Keratoplasty is a surgical procedure capable of partially restoring the visual function of patients affected by corneal diseases. There are risk factors such as corneal vascularization or preoperative diagnosis that could serve as predictors of failure in different types of Corneal Transplantation. DMEK is postulated as one of the most effective procedures for the treatment of diseases that affect the corneal endothelium; but it is necessary to carry out studies with multivariate models to confirm these hypotheses.

Financial Disclosure:

None