What to Do When Facing a Failed Corneal Regraft
Corneal regraft survival was found to vary depending on the indication for first graft surgery, according to an examination involving nearly 10,000 regrafts. Additionally, for Fuchs endothelial dystrophy (FED) it varied based on the type of regraft performed.
Investigators used the UK’s national transplant registry to look at the corneal transplant replacement survival rates over a 17-year period ending in early 2016. They looked at 5-year survival rates for penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty for keratoconus; PK and endothelial keratoplasty (EK) for Fuchs endothelial dystrophy (FED); and pseudophakic bullous keratopathy (PBK). Among the results:
- PK was used in nearly three-fourths of the cohort.
- EK represented 3% of all regrafts in 2005-2006, vs 38% in 2015-2016.
- A median of 28 months passed before first regraft for all graft types.
- Stratification of 5-year survival was seen for successive grafts
- Survival after lamellar and PK procedures was similar for first regrafts in keratoconus and PBK.
- There was a higher regraft survival after PK for FED (71%) vs EK (55%).
The authors noted that their results can help aid decisions when facing a failed corneal transplant.
Aboshiha J, Jones M, Hopkinson C, Larkin D. Differential survival of penetrating and lamellar transplants in management of failed corneal grafts. JAMA Ophthalmol. 2018;136(8):859-865. doi: 10.1001/jamaophthalmol.2018.1515.
