Outcome of corneal transplant rejection: a 10-year study.
OBJECTIVE
To study the incidence of graft rejection and the predictive factors for its reversibility.


METHODS
It is a retrospective study of 1927 consecutive penetrating keratoplasties performed between January 1990 and January 2000 with more than 6 months follow up. A total of 224 rejection episodes were noted in 183 patients. Of these, 184 first rejection episodes were included in this study.


RESULTS
The incidence of first rejection episode was 9.55%. Of patients 87% were symptomatic during the episode with vision loss being the commonest. The average time of onset of rejection was 15.25 +/- 14.4 months (median 11.7 months). In total, 53.3% of rejections occurred within 1 year after surgery. Of the patients who completed minimum 3 months follow up after the rejection episode, the rate of reversibility was 63.3%. Major predictive factors for a poor outcome after rejection were repeated grafting and associated anterior vitrectomy during surgery. The reversibility of the episode did not differ significantly with the modality of treatment used, but treatment with intravenous steroids within 7 days of onset of rejection may have a role in reducing the recurrences of rejection episodes, thus increasing the graft survival.


CONCLUSIONS
Regrafts and associated anterior vitrectomy were significant risk factors for a poor outcome following rejection episode.
Sangwan
Virender S
VS
Cornea and Anterior Segment Services, LV Prasad Eye Institute, Hyderabad, India.
Ramamurthy
Balasubramanya
B
Shah
Urmi
U
Garg
Prashant
P
Sridhar
Mitthanamalli S
MS
Rao
Gullapalli N
GN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000503:physiopathology*; D003316:Corneal Diseases / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000503:physiopathology*; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007223:Infant; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014821:Vitrectomy