Ple-plakon Patricia A, Shtein Roni M, Musch David C, Blachley Taylor, Saponara Fiorella, Woodward Maria A
Departments of *Ophthalmology and Visual Sciences, and †Epidemiology, University of Michigan, Ann Arbor, MI; and ‡Department of Ophthalmology, New York Presbyterian Hospital/Columbia University, New York, NY.
Cornea. 2013 Oct;32(10):1339-43. doi: 10.1097/ICO.0b013e3182a0d154.
To determine whether donor or tissue characteristics of corneas for transplantation are predictive of reported adverse events occurring in the early postoperative period.
We compared preoperative donor and tissue characteristics of corneal tissues with or without reported adverse events from 2007 to 2011. Adverse event categories included primary graft failure, infection, surgical causes, recipient-related etiologies, and other causes. We included corneas transplanted via penetrating keratoplasty (PK) and endothelial keratoplasty (EK).
Of 20,431 tissues included, there were 251 (1.2%) reported adverse events. Among all transplanted tissues, 67% were used for PK, and 33% were used for EK. The adverse event occurrence rate was 0.78% in PK versus 2.12% in EK (P < 0.0001). The donor characteristics associated with adverse events were male gender (P = 0.01) and cancer history (P = 0.03), which were associated with primary graft failure. In PK, the most frequently reported causes within 106 adverse events were recipient-related causes (n = 41, 0.30% of total PK tissues) and infection (n = 31, 0.23%). In EK, the most frequently reported causes within 145 adverse events were surgical complications (n = 72, 1.05% of total EK tissues) and primary graft failure (n = 41, 0.60%).
The rate of reported adverse events was low. Adverse events more commonly occurred after EK. Increased rate of primary graft failure was associated with male donors and donors with a cancer history. Postcut tissue thickness, only in the year 2007, was the sole tissue characteristic associated with adverse events.
确定用于移植的角膜的供体或组织特征是否可预测术后早期报告的不良事件。
我们比较了2007年至2011年有或无不良事件报告的角膜组织的术前供体和组织特征。不良事件类别包括原发性移植失败、感染、手术原因、受者相关病因和其他原因。我们纳入了通过穿透性角膜移植术(PK)和内皮角膜移植术(EK)移植的角膜。
在纳入的20431个组织中,有251个(1.2%)报告了不良事件。在所有移植组织中,67%用于PK,33%用于EK。PK的不良事件发生率为0.78%,而EK为2.12%(P<0.0001)。与不良事件相关的供体特征是男性(P = 0.01)和癌症病史(P = 0.03),这与原发性移植失败相关。在PK中,106例不良事件中最常报告的原因是受者相关原因(n = 41,占PK组织总数的0.30%)和感染(n = 31,0.23%)。在EK中,145例不良事件中最常报告的原因是手术并发症(n = 72,占EK组织总数的1.05%)和原发性移植失败(n = 41,0.60%)。
报告的不良事件发生率较低。不良事件在EK后更常见。原发性移植失败率增加与男性供体和有癌症病史的供体相关。仅在2007年,切割后组织厚度是与不良事件相关的唯一组织特征。