Management and Treatment Outcomes of High-Risk Corneal Transplantations.
Karolina UrbanskaMarcin WoźniakPiotr WięsykNatalia KonarskaWeronika BartosMateusz BiszewskiMichal Jakub BielakTomasz ChorągiewiczRobert RejdakPublished in: Journal of clinical medicine (2022)
Corneal transplantation is the most effective treatment for corneal blindness. Standard planned keratoplasties have a high success rate. Conditions such as active inflammation at the time of surgery, the presence of ocular surface disease, previous graft disease, or neovascularization make them more susceptible to rejection. These are so-called high-risk corneal transplantations. In our study, we selected 52 patients with a higher risk of graft rejection. A total of 78 procedures were performed. The main indications for the first keratoplasty were infections (59.6%) and traumas (21.2%). Visual acuity (VA) significantly improved from 2.05 logMAR on the day of keratoplasty to 1.66 logMAR in the latest examination ( p = 0.003). An analysis of the graft survival showed a 1-year survival of 54% and a 5-year survival of 19.8% of grafts. The mean observation time without complications after the first, second, and third surgery was 23, 13, and 14 months, respectively. The best results were noted among patients with infectious indications for keratoplasty ( p = 0.001). Among them, those with bacterial infection had the best visual outcomes ( p = 0.047).
Keyphrases
- optical coherence tomography
- minimally invasive
- wound healing
- coronary artery bypass
- cataract surgery
- free survival
- oxidative stress
- surgical site infection
- diabetic retinopathy
- type diabetes
- vascular endothelial growth factor
- metabolic syndrome
- coronary artery disease
- mesenchymal stem cells
- skeletal muscle
- combination therapy
- insulin resistance
- replacement therapy