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Lid disease, central ALK, peripheral grafts may pose risks for tectonic graft failure
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Severe lid disease, central anterior lamellar keratoplasty and peripheral grafts were linked to increased anatomic failure of tectonic corneal grafts, according to a study.
“Tectonic grafts are vital in restoring globe integrity in patients with descemetoceles and corneal perforation. Our study found that risk factors for anatomic failure included patients with lid disease, central ALK, and peripheral grafts. However, our results suggest that the long-term physiologic graft survival was better for ALK compared with PK for these tectonic indications,” the study authors said.
The retrospective cohort study examined 362 eyes of 362 participants with a mean age of 51.5 years who underwent corneal transplantation for tectonic indications; 142 had PK, 68 had anterior lamellar keratoplasty, and 93 had a peripheral corneoscleral patch graft.
Mean follow-up was 25.8 months.
Among 223 anatomically successful grafts, the probability of survival at 10 years was 66.8% for anterior lamellar keratoplasty and 44.2% for PK.
The risk factors for physiologic graft failure in anatomically successful central grafts were active corneal inflammation (P = .003) and large donor and recipient graft sizes of at least 9 mm (P = .006).
Potential study limitations included the retrospective design and the potential for differences in disease severity between the surgical groups, the authors noted.
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Ophthalmology. 2012;119(7):1311-1319.
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