title: Prognostic factors for corneal graft recovery after severe corneal graft rejection following penetrating keratoplasty.
abstract: BACKGROUND
  To investigate the outcome and prognostic factors for corneal graft recovery after severe corneal graft rejection following penetrating keratoplasty (PKP) treated with topical and systemic steroids.
  
  
  METHODS
  Fifty-eight eyes in 58 patients with severe corneal graft rejection following PKP were treated with topical and systemic steroids. Factors affecting the reversibility and maintenance of graft transparency were analyzed.
  
  
  RESULTS
  Graft transparency was restored in 37 of 58 eyes (63.8%). Clarity of the graft was maintained in 25 of 37 eyes after transparency was restored, while corneal decompensation developed at a mean of 6.0 ± 4.3 months in the remainder. The interval between rejection and treatment with systemic steroids was shorter in cases that recovered graft transparency (OR, 0.88, 95% CI. 0.80-0.97, P = 0.0093). Corneal decompensation after the recovery of corneal transparency tend to occur in cases of regraft (OR, 0.09, 95% CI. 0.01-0.54, P = 0.0091).
  
  
  CONCLUSIONS
  Severe corneal graft rejection after PKP was reversible in approximately two-thirds of the cases, with graft transparency being maintained in two-thirds of them when treated with both topical and systemic steroids. Early treatment confers a benefit in terms of the recovery of graft transparency.
authors: Department of Ophthalmology, Tokyo Dental College, 5-11-13 Sugano, Ichikawa, Chiba 272-8513, Japan. kyamazoe1528@yahoo.co.jp
authors: Katsuya
authors: K
authors: Yamazoe
authors: Kyoko
authors: K
authors: Yamazoe
authors: Seika
authors: S
authors: Shimazaki-Den
authors: Jun
authors: J
authors: Shimazaki
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003316:Corneal Diseases / Q000601:surgery; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone