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Margareta Claesson, John Armitage; Clinical outcome of repeat penetrating keratoplasty. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3099.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to compare the clinical outcome of regrafts with first grafts.
Two-year outcome data were obtained from the Swedish Cornea Transplant Register for patients undergoing penetrating keratoplasty (PK) between 2001and 2008. The survival and visual outcome of regrafts with the original diagnoses of keratoconus, Fuchs’ endothelial dystrophy (FED) or bullous keratopathy (BK) were compared with first grafts for the same diagnoses by univariate and logistic regression methods.
The failure rate for grafts in keratoconus increased three-fold in regrafts compared with first grafts (i.e., 17% vs. 6%, p=0.002) doubled in FED regrafts (33% vs. 15%, p=0.001). In BK, the failure rate was already high in first grafts and the increase in failure of regrafts was minimal (p=0.9). Visual acuity was also worse in regrafts compared to first grafts, mainly in the keratoconus and FED patients. In the keratoconus group, visual acuity with preferred correction was ≥0.5 in 69% of first grafts compared with only 55% in regrafts (p=001). In FED 52% of first grafts but only 19% of regrafts achieved VA ≥0.5, (p=0.001). The visual outcome of regrafts in BK was poor but little different from first grafts where fewer than 20% achieved VA ≥0.5.
This analysis confirmed the poorer survival of regrafts where the original indication was keratoconus or FED. In addition, visual outcome was also worse than in first grafts. However, the outcomes for regrafts in BK were similar to first grafts.
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