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Patient, donor age linked to risk of PK graft failure after endothelial rejection

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Among penetrating keratoplasty patients who experience an episode of severe endothelial rejection, older patients and those who received a graft from an older donor are at an increased risk for post-rejection graft failure, according to a retrospective study.

Michael D. Wagoner, MD, and colleagues evaluated corneal graft survival in 152 patients treated with 157 PK procedures and who experienced severe endothelial rejection.

Surgeons were able to reverse the rejection episodes during the first 3 months in 90 grafts (57.3%). Overall, 42.6% of grafts had survived at 1 year and 36.1% had survived at 3 years, according to the study.

"The surgical indication for PK significantly correlated with the likelihood of reversibility (P < .001) and long-term graft survival (P < .001)," the authors said.

Specific risk factors associated with post-rejection graft failure included increasing donor age (P = .004), increasing patient age (P < .001) and a history of rejection episodes (P = .002), they noted.

The study is published in the September issue of Ophthalmology.