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H. B. Sellevoll, W. J. Armitage, M. S. Figueiredo, R. S. M. Figueiredo, F. C. Figueiredo; Long-Term Outcomes of Corneal Transplantation. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2200.
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To evaluate the clinical outcomes of penetrating keratoplasty patients in a single tertiary centre in the United Kingdom (UK). The Newcastle Corneal Transplant Registry (NCTR) is an 11-year prospective study.
The NCTR is a prospective, single-centre, noncomparative, interventional case series of 529 consecutive corneal transplants by one surgeon.
Mean follow-up was 55 months (range 10-125 months). 142 patients were male with a mean age of 59 years (SD 21, range 7-93). 225 transplants were entered at the start of the 5-year follow-up period: 17 failed at 5 years, but no failures were seen in the keratoconus, Fuchs’ or infections groups. Five-year survival was 79% (95% CI 62, 96) for bullous keratopathy, 73% (95% CI 56, 90) for regrafts, and 56% (95% CI 22, 90) for ‘other’ indications. Survival was influenced by indication (p<0.0001). Mean donor ECD was 2616 cells/mm² (SD 250). ECD fell to 898 cells/mm² (SD 470) by 5 years, giving an overall cell loss of 66% (SD 18), ranging from 61% (SD 21) for keratoconus to 75% (SD 15) for bullous keratopathy and 75% (SD 9) for regrafts. Indication had no influence on cell loss (p=0.25).
Corneal graft survival was influenced by indication and our data demonstrated survival at 5 years comparable to other studies. The endothelial cell loss at 5 years demonstrates continued endothelial instability/dysfunction that may result in late graft failure. Original pathology does not influence endothelial cell loss postoperatively. The NCTR offers a unique opportunity to analyse the long-term outcomes of corneal transplantation in a UK ophthalmic unit and to guide clinical practice.
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