A Detailed Analysis of Individuals Having Graft Failure After Corneal Transplantation.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-11-01 Epub Date: 2024-05-16 DOI:10.1080/08820538.2024.2354693

Fulya Duman, Arzu Guler, Mustafa Kosker, Amir A Azari, Deniz Marangoz, Kristin M Hammersmith, Parveen K Nagra, Christopher J Rapuano

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引用次数: 0

Abstract

Purpose: To describe demographic and clinical characteristics of patients with graft failure after keratoplasty, determine the cause of graft failure and outcomes.

Methods: The charts of patients between 2008-2013 in the Cornea Service at Wills Eye Hospital with a history of a corneal transplant before the end of 2012 were retrospectively reviewed. Included were patients who had graft failure after corneal transplantation and had at least one year of follow-up after transplantation. Penetrating keratoplasty (PK) and Descemet's stripping endothelial keratoplasty (DSEK) patients were analyzed separately.

Results: A total of 186 eyes of 170 patients with graft failure after a PK (156) or DSEK (30) procedures were identified. The baseline characteristics included 100 female and 70 male patients with an age between 0 and 90 years (median 63 years). At the time of surgery, 38% had three or more systemic diseases and 68% were using three or more systemic medicines. Mean follow up time for PK was nearly four times of DSEK. Only 2 DSEK eyes (7%) underwent a 3rd DSEK graft, while 47 (30%) PK eyes underwent a 3^rd PK and 15 (10%) PK eyes underwent more than three PK procedures.

Conclusions: Most DSEK failures occurred in 1^st year, while graft failure in PKs is scattered over years. Failure in DSEK is mostly due to graft or surgical risk factors but in PK mostly due to factors in the host. DSEK does not appear to be as affected by the patients' demographic and clinical characteristics as much as PK.

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角膜移植手术后移植失败者的详细分析。

目的：描述角膜移植术后移植失败患者的人口统计学和临床特征，确定移植失败的原因和结果：回顾性分析威尔斯眼科医院角膜科 2008-2013 年期间 2012 年底前接受过角膜移植手术的患者病历。其中包括角膜移植手术后出现移植失败且移植后随访至少一年的患者。对穿透性角膜移植术（PK）和去角膜剥脱内皮角膜移植术（DSEK）患者分别进行了分析：结果：共确定了 170 名患者中的 186 只眼睛，这些患者在接受 PK（156 例）或 DSEK（30 例）手术后出现移植失败。基线特征包括 100 名女性和 70 名男性患者，年龄在 0 至 90 岁之间（中位数为 63 岁）。手术时，38%的患者患有三种或三种以上的系统性疾病，68%的患者正在使用三种或三种以上的系统性药物。PK 的平均随访时间几乎是 DSEK 的四倍。只有2只DSEK眼（7%）接受了第3次DSEK移植，而47只PK眼（30%）接受了第3次PK，15只PK眼（10%）接受了3次以上的PK手术：结论：大多数DSEK手术失败发生在第一年，而PK手术的移植失败则分散在数年内。DSEK的失败主要是移植物或手术风险因素造成的，而PK的失败主要是宿主因素造成的。DSEK 受患者人口统计学和临床特征的影响似乎不如 PK 大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.