Tariq Almudhaiyan1, Mohammed AlAmry1, Rajiv Khandekar2,3, Huda AlGhadeer4. 1. Emergency Department, King Khaled Eye Specialist Hospital, PO box 7191, Riyadh, 11462, Saudi Arabia. 2. Research department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. 3. British Columbia Center for Epidemiologic and International Ophthalmology, UBC, Vancouver, Canada. 4. Emergency Department, King Khaled Eye Specialist Hospital, PO box 7191, Riyadh, 11462, Saudi Arabia. hghadeer@kkesh.med.sa.
Abstract
PURPOSE: To evaluate the characteristics of patients with post-keratoplasty complications and their presentation at an emergency center. DESIGN: Retrospective one-armed cohort study. METHODS: Data were evaluated on patients who underwent corneal grafts in 2019 and presented to an emergency unit. Data were collected on patient demographics, presenting symptoms, clinical details, diagnosis at emergency visit, final diagnosis, best-corrected visual acuity (BCVA) at presentation and at the last follow-up after management. Severe visual impairment (SVI) and graft rejection were tested for correlations to other factors. RESULTS: The study sample was comprised of 149 eyes of 124 patients with a mean age of 27.5 years. Keratoconus was the indication for keratoplasty in 94 (75.8%) patients. The main presenting symptoms were pain 57 (38.3%) and red eye in 52 (34.9%) patients. The median interval between emergency visit and keratoplasty was 1.6 years. There were 63 (42.3%) patients who had emergency visits due to suture-related problems. The rates of SVI and graft rejection at the time of discharge after managing emergencies in eyes with previous keratoplasty were 14.1% (95% CI 8.5; 19.7) and 13.4 (95% CI 7.9; 18.9), respectively. Keratoconus (OR = 22.8) and young age (P < 0.001) were negatively associated with SVI after management. CONCLUSION: Patients with keratoplasty are at high risk for severe vision loss and should be counseled to seek urgent eye care for early detection and management of sight-threatening complications to improve graft survival and vision.
PURPOSE: To evaluate the characteristics of patients with post-keratoplasty complications and their presentation at an emergency center. DESIGN: Retrospective one-armed cohort study. METHODS: Data were evaluated on patients who underwent corneal grafts in 2019 and presented to an emergency unit. Data were collected on patient demographics, presenting symptoms, clinical details, diagnosis at emergency visit, final diagnosis, best-corrected visual acuity (BCVA) at presentation and at the last follow-up after management. Severe visual impairment (SVI) and graft rejection were tested for correlations to other factors. RESULTS: The study sample was comprised of 149 eyes of 124 patients with a mean age of 27.5 years. Keratoconus was the indication for keratoplasty in 94 (75.8%) patients. The main presenting symptoms were pain 57 (38.3%) and red eye in 52 (34.9%) patients. The median interval between emergency visit and keratoplasty was 1.6 years. There were 63 (42.3%) patients who had emergency visits due to suture-related problems. The rates of SVI and graft rejection at the time of discharge after managing emergencies in eyes with previous keratoplasty were 14.1% (95% CI 8.5; 19.7) and 13.4 (95% CI 7.9; 18.9), respectively. Keratoconus (OR = 22.8) and young age (P < 0.001) were negatively associated with SVI after management. CONCLUSION: Patients with keratoplasty are at high risk for severe vision loss and should be counseled to seek urgent eye care for early detection and management of sight-threatening complications to improve graft survival and vision.
Authors: Mario Matthaei; Heike Sandhaeger; Martin Hermel; Werner Adler; Albert S Jun; Claus Cursiefen; Ludwig M Heindl Journal: Transplantation Date: 2017-06 Impact factor: 4.939
Authors: W John Armitage; Christine Goodchild; Matthew D Griffin; David J Gunn; Jesper Hjortdal; Paul Lohan; Conor C Murphy; Uwe Pleyer; Thomas Ritter; Derek M Tole; Bertrand Vabres Journal: Transplantation Date: 2019-12 Impact factor: 4.939