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Prognostic factors for corneal graft recovery after severe corneal graft rejection following penetrating keratoplasty

机译:穿透性角膜移植术后严重角膜移植排斥反应后角膜移植物恢复的预后因素

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Background To investigate the outcome and prognostic factors for corneal graft recovery after severe corneal graft rejection following penetrating keratoplasty (PKP) treated with topical and systemic steroids. Methods Fifty-eight eyes in 58 patients with severe corneal graft rejection following PKP were treated with topical and systemic steroids. Factors affecting the reversibility and maintenance of graft transparency were analyzed. Results Graft transparency was restored in 37 of 58 eyes (63.8%). Clarity of the graft was maintained in 25 of 37 eyes after transparency was restored, while corneal decompensation developed at a mean of 6.0?±?4.3 months in the remainder. The interval between rejection and treatment with systemic steroids was shorter in cases that recovered graft transparency (OR, 0.88, 95% CI. 0.80–0.97, P?=?0.0093). Corneal decompensation after the recovery of corneal transparency tend to occur in cases of regraft (OR, 0.09, 95% CI. 0.01–0.54, P?=?0.0091). Conclusions Severe corneal graft rejection after PKP was reversible in approximately two-thirds of the cases, with graft transparency being maintained in two-thirds of them when treated with both topical and systemic steroids. Early treatment confers a benefit in terms of the recovery of graft transparency.
机译:背景研究局部和全身性类固醇治疗穿透性角膜移植术(PKP)后严重角膜移植排斥后角膜移植物恢复的结果和预后因素。方法对58例PKP术后严重角膜移植排斥反应的58眼进行局部和全身激素治疗。分析了影响移植物透明度的可逆性和维持性的因素。结果58眼中的37眼恢复了嫁接透明性(63.8%)。恢复透明后,在37眼中的25眼中保持移植物的清晰度,而在其余时间内平均角膜代偿失调发生在6.0±4.3个月。恢复移植物透明性的情况下,排斥反应和全身性类固醇激素治疗之间的间隔更短(OR,0.88,95%CI,0.80-0.97,P = 0.0093)。移植后往往会发生角膜透明性恢复后的角膜代偿失调(OR,0.09,95%CI。0.01-0.54,P = 0.0091)。结论大约三分之二的病例可逆转PKP后严重的角膜移植排斥反应,其中局部和全身性类固醇激素治疗可保持三分之二的移植物透明性。早期治疗在恢复移植物透明性方面具有益处。

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