title: [Factors Affecting Outcomes of Repeated Penetrating Keratoplasty].
abstract: OBJECTIVE
  To investigate prognosis for repeated penetrating keratoplasty (PKP) and factors that affect the outcome.
  
  
  METHODS
  We retrospectively investigated graft survival rates, 1-year postoperative best-corrected visual acuity and irreversible rejection rates in 108 eyes of 106 patients that had repeated PKP. Factors that might affect the outcome were, age, number of previous PKP, original diseases, history of glaucoma and rejection and the use of postoperative immunosuppressant were also studied.
  
  
  RESULTS
  Individual-factor analysis showed that history of rejection and postoperative immunosuppressant significantly increased the risk of postoperative rejection. Multi-factor analysis showed that graft survival rate was significantly lower among cases that had systemic immunosuppressants (steroids and cyclosporine). One year postoperative best-corrected visual acuity was significantly worse in cases that had history of glaucoma. In cases with history of rejection, systemic administration of postoperative immunosuppressants was significantly associated with postoperative irreversible rejection.
  
  
  CONCLUSIONS
  History of rejection and glaucoma tend to have poor outcome, and the outcome might not improve by postoperative immunosuppressants.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Machiko
authors.initials: M
authors.lastname: Shimmura-Tomita
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Satake
authors.forename: Seika
authors.initials: S
authors.lastname: Shimazaki-Den
authors.forename: Shigeto
authors.initials: S
authors.lastname: Shimmura
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
mesh_terms: D000368:Aged; D003316:Corneal Diseases / Q000601:surgery*; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine