Corneal graft failure: a long-term retrospective multicentric analysis

Session Details

Session Title: Surgical Cornea: Keratoplasty & Corneal Grafts

Session Date/Time: Sunday 23/09/2018 | 14:00-16:00

Paper Time: 15:42

Venue: Room A3, Podium 3

First Author: : A.Montesel SPAIN

Co Author(s): :    R. Barraquer   F. Munoz Negrete   M. Teus   R. Gutierrez   M. Maldonado   J. Alio     

Abstract Details

Purpose:

This study wants to investigate the cases of corneal graft failure occurred in 6 tertiary centers of the RETICS network from 2001 to 2016. The causes and rates of failure were examinated in relations to the different pathological pathways and keratoplasty surgical techniques.

Setting:

Centro de Oftalmologia Barraquer, Barcelona, Vissum Instituto Oftalmologico de Alicante, Alicante, Hospital Universitario Ramon y Cajal, Madrid, Hospital Universitario Principe de Asturias de Alcala`, Alcala`, University of Murcia Medical School, Murcia, Hospital Clinico Universitario Valladolid, Valladolid.

Methods:

A retrospective review has been performed on clinical records of all patients that underwent any kind of corneal transplant from 2001 to 2016 in the study centers. Inclusion criteria involved the presence of detailed pre-operative examination, surgical report and at least 12 months follow-up after surgery. The cases of failure were primarily classified by mechanism of failure (primary failure, immunological allograft rejection, failure in absence of rejection) and for type of transplant. A second analysis was performed on main indications for keratoplasy, host risk factors and co-morbidity and on the size, age and cellularity of the graft.

Results:

This study has recruited 5.000 keratoplasties procedures. The cases of failure were evaluated by causes and type of the transplant. The main cause resulted to be the immunological rejection while the main risk factor was the presence of a previous failed graft. According to the type of transplant the failure rate was between 17% -27%.

Conclusions:

Corneal transplant is a challenging surgery still complicated by a relative high risk of failure. The survival rate of the graft differs considerably in relations of the indications and the different surgical techniques. Analyzing the different mechanisms of failure is essential to increase the awareness of corneal graft physiopathology with the aim of improving the success rate of this surgery.

Financial Disclosure:

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