Parwez Hossain 1,2 , Abdo Karim Tourkmani 2 , Dimitri Kazakos 1 , Mark Jones 3 , David Anderson 2 Show Affiliations »
Abstract
BACKGROUND: Corneal graft (CG) surgery is the most common and successful tissue transplant worldwide. A small and important group of patients are operated in emergency situations, typically to save a perforated eye. Our knowledge of the indications and outcomes of emergency corneal graft (eCG) is limited. METHODS: Retrospective, multifactorial analysis of all CGs registered by the UK Transplant Service from April 1999 to March 2005. RESULTS: A total of 12 976 CGs were performed. 1330 (11.4%) were eCGs including 433 regrafts. Actual perforation occurred in 876 (65.9%) patients. 420 (31.5%) grafts were for tectonic purposes alone and 217 (16.3%) were also grafted for visual rehabilitation. The main diagnostic categories were infection (39.4%), non-infectious ulcerative keratitis (32.2%) and other causes (ectasias, previous ocular surgery, injury, dystrophies and opacification). Graft survival of first eCG at 1, 2 and 5 years was 78%, 66% and 47%, respectively. Best-corrected visual acuity of surviving grafts at 1 year was: 6/12 or better in 29.9%, 6/18 to 6/60 in 38.4%, counting finger to LP in 30.6% and NPL in 1%, with worsening of vision in only 8.7% of the patients. CONCLUSION: This study which is the largest of its kind shows that despite the seriousness of the critical corneal pathology and the surgical challenges that it poses, the outcomes of eCG are favourable with most patients keeping their eyesight and avoiding immediate rejection. These clinical outcomes show the value of eye banking facilities that are developed to support corneal tissue supply for eCG. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
BACKGROUND: Corneal graft (CG) surgery is the most common and successful tissue transplant worldwide. A small and important group of patients are operated in emergency situations, typically to save a perforated eye. Our knowledge of the indications and outcomes of emergency corneal graft (eCG ) is limited. METHODS: Retrospective, multifactorial analysis of all CGs registered by the UK Transplant Service from April 1999 to March 2005. RESULTS: A total of 12 976 CGs were performed. 1330 (11.4%) were eCGs including 433 regrafts. Actual perforation occurred in 876 (65.9%) patients . 420 (31.5%) grafts were for tectonic purposes alone and 217 (16.3%) were also grafted for visual rehabilitation. The main diagnostic categories were infection (39.4%), non-infectious ulcerative keratitis (32.2%) and other causes (ectasias , previous ocular surgery, injury, dystrophies and opacification). Graft survival of first eCG at 1, 2 and 5 years was 78%, 66% and 47%, respectively. Best-corrected visual acuity of surviving grafts at 1 year was: 6/12 or better in 29.9%, 6/18 to 6/60 in 38.4%, counting finger to LP in 30.6% and NPL in 1%, with worsening of vision in only 8.7% of the patients . CONCLUSION: This study which is the largest of its kind shows that despite the seriousness of the critical corneal pathology and the surgical challenges that it poses, the outcomes of eCG are favourable with most patients keeping their eyesight and avoiding immediate rejection. These clinical outcomes show the value of eye banking facilities that are developed to support corneal tissue supply for eCG . © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Entities: Chemical
Disease
Gene
Species
Keywords:
Cornea; Immunology; Trauma; infection
Mesh： See more »
Year: 2017
PMID： 28495906 DOI： 10.1136/bjophthalmol-2016-309870
Source DB: PubMed Journal: Br J Ophthalmol ISSN： 0007-1161 Impact factor: 4.638