Keratoplasty Outcomes in Patients With Uveitis. Issue 5 (May 2021)

• Record Type: Journal Article
• Authors: Hennein, Lauren; Lambert, Nathan G.; Chamberlain, Winston; Hirabayashi, Kristin; Rose-Nussbaumer, Jennifer; Schallhorn, Julie M.
• Is Part Of: Cornea. Volume 40:Issue 5(2021)
• Publication Date: 2021-05
• Subjects: corneal transplant -- keratoplasty -- uveitis; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000002527
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Purpose: To examine the corneal transplant failure rates and associations with uveitic eye disease. Methods: The retrospective chart review identified 70 eyes from 42 patients with uveitis that underwent 40 primary transplants and 30 repeat transplants at 2 major academic centers over a 9-year period. The graft failure rate was calculated. Variables hypothesized to be associated with graft failure were analyzed as covariates using a Cox proportional hazards analysis clustered by the patients to determine their association with failure rates. Results: Of the 70 grafts, the mean duration of follow-up for patients was 40.6 months (range 4–90 months) and the median survival time was 24.1 months (interquartile range of 9–290 months). Twenty-two patients (52%) had graft failure. There was a higher rate of graft failure in patients with infectious uveitis as compared to those with noninfectious uveitis (hazard ratio 2.46, P = 0.031). Patients with successful grafts had their inflammation controlled for a longer period of time before transplantation as compared to those with failed grafts (38.6 vs. 13.6 months, P = 0.004). Worse preoperative visual acuities were significantly associated with graft failure ( P < 0.001). Conclusions: There is limited knowledge of corneal transplant outcomes in uveitic patients in the current literature. In our study, over half of the grafts failed. Infectious uveitis (especially viral) was a strong predictor of graft failure. A shorter period of inflammation control before transplantation, previously failed grafts, and worse preoperative visual acuity were also associated with graft failure. Abstract : Supplemental Digital Content is Available in the Text.