Prior Contralateral Penetrating Keratoplasty Is a Risk Factor for Second Eye Graft Rejection. (7th February 2023)

• Record Type: Journal Article
• Authors: Shiuey, Eric J.; Zhang, Qiang; Rapuano, Christopher J.; Ayres, Brandon D.; Hammersmith, Kristin M.; Nagra, Parveen K.; Syed, Zeba A.
• Is Part Of: Ocular immunology and inflammation. Volume 31:Number 2(2023)
• Page Start: 257
• Page End: 262
• Publication Date: 2023-02-07
• Subjects: Penetrating keratoplasty -- graft rejection -- cornea -- immunology -- inflammation; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2021.2024860
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Aims: To determine whether prior penetrating keratoplasty (PK) in the contralateral eye increases risk of second eye PK graft rejection. Methods: Cohort study of 593 consecutive PKs in transplant-naïve eyes (500 unilateral cases, 93 second eyes). Outcomes were compared between PKs performed in eyes with versus without a history of prior contralateral eye PK. Risks of rejection and failure were estimated using Cox proportional hazards models. Results: Mean age was 53.7 ± 23.3 years; average follow-up was 4.00 ± 2.87 years. Rejection occurred in 211 (35.6%) grafts. The incidence of rejection was 34.0% in unilateral cases and 44.1% in second eyes with PK in the contralateral eye. Prior contralateral PK was a significant risk factor for graft rejection (HR = 1.42, 95% CI 1.01–2.01, p = .045) Conclusion: Contralateral PK is associated with increased risk of second eye graft rejection. Loss of ocular immune privilege is a possible mechanism.