Department of Ophthalmology, Tokyo Dental College, 5-11-13 Sugano, Ichikawa, Chiba 272-8513, Japan.
BMC Ophthalmol. 2013 Feb 25;13:5. doi: 10.1186/1471-2415-13-5.
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.
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.
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).
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.
研究穿透性角膜移植术后(PKP)严重角膜移植排斥反应后经局部和全身皮质类固醇治疗的角膜移植恢复的结果和预后因素。
58 例 PKP 后严重角膜移植排斥反应患者接受局部和全身皮质类固醇治疗。分析影响移植物透明度可逆性和维持的因素。
58 只眼中有 37 只(63.8%)恢复了透明性。在恢复透明性的 37 只眼中,有 25 只保持了移植物的清晰度,而其余的在平均 6.0±4.3 个月后发生了角膜失代偿。在恢复透明性的病例中,排斥反应与全身皮质类固醇治疗之间的间隔较短(OR,0.88,95%CI.0.80-0.97,P=0.0093)。角膜透明性恢复后角膜失代偿的倾向于发生在再次移植的病例中(OR,0.09,95%CI.0.01-0.54,P=0.0091)。
PKP 后严重角膜移植排斥反应约有三分之二是可逆的,在接受局部和全身皮质类固醇治疗后,其中三分之二的患者保持了移植物的透明性。早期治疗有助于恢复移植物的透明度。