History of PK increases risk for graft rejection in other eye
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PHILADELPHIA — A history of contralateral penetrating keratoplasty is associated with an increased risk for second eye graft rejection, according to a study presented at the Wills Eye Conference.
“The purpose of our study was to identify if the history of PK in the contralateral eye increases the risk of graft rejection in the second eye,” Cherie Fathy, MD, said.
In a retrospective chart review of consecutive PKs at Wills Eye Hospital from May 2007 to September 2018, 1,029 procedures were performed in 903 eyes of 835 patients. Of these eyes, 636 were included in the final analysis. Average patient age at the time of transplant was 53.6 years.
After multivariate analysis, prior PK in the other eye, a history of anterior uveitis, and whether the patient was aphakic or had an anterior chamber IOL vs. being phakic were all significant risk factors for graft rejection.
Primary outcome was the rate of graft rejection, and secondary outcomes included the length of time to graft rejection, graft failure and re-graft rate.
“Results showed that while there was an increased risk for rejection, prior PK in the contralateral eye was not associated with eventual graft failure,” Fathy said.
Priming of the immune system from a first eye transplant may be a possible mechanism for contralateral eye graft rejection, but further research is needed to understand the pathophysiology of this association, she said. – by Kate Burba
Reference:
Fathy C. History of contralateral penetrating keratoplasty as a risk factor for second eye graft rejection. Presented at: Wills Eye Conference; March 5-7, 2020; Philadelphia.
Disclosure: Fathy reports no relevant financial disclosures.