Clinical and surgical factors influencing corneal graft survival, visual acuity, and astigmatism. Corneal Transplant Follow-up Study Collaborators.
OBJECTIVE
To quantify clinical and operative factors that influence corneal graft outcome.


METHODS
A multifactorial analysis was done on 2242 corneal grafts registered by the United Kingdom Transplant Service from July 1987 to June 1991.


RESULTS
There was an increased risk of graft failure in patients with preoperative diffuse and other noncentral stromal edema, less-common eye diseases, small trephine size, difference in donor and recipient sizes greater than 0.25 mm, and use of mixed continuous and interrupted sutures. Visual acuity 3 months after surgery was poorer in patients who had glaucoma and low visual acuity preoperatively, small trephine size, and combined vitreous surgery. Use of interrupted sutures resulted in higher astigmatism at 3 months.


CONCLUSIONS
After allowing for the effects of recipient factors, surgical factors significantly affected corneal graft outcome. No factors that showed significant benefits for graft survival also adversely affected visual performance. Details of medical history, clinical condition, and surgical method failed to predict more than a small proportion of observed variability in visual performance of functioning grafts.
Vail
A
A
Institute of Epidemiology and Health Services Research, University of Leeds, England.
Gore
S M
SM
Bradley
B A
BA
Easty
D L
DL
Rogers
C A
CA
Armitate
W J
WJ
D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology*; D003315:Cornea / Q000502:physiology*; D016039:Corneal Transplantation / Q000009:adverse effects / Q000502:physiology*; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D011183:Postoperative Complications; D012307:Risk Factors; D013536:Suture Techniques / Q000009:adverse effects; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*