Nandzik Magdalena, Wylęgała Adam, Szkodny Dominika, Wróblewska-Czajka Ewa, Wylęgała Edward, Orzechowska-Wylęgała Bogusława
Department of Ophthalmology, Faculty of Medical Sciences, Zabrze Medical University of Silesia, 40-760 Katowice, Poland.
Department of Ophthalmology, District Railway Hospital in Katowice, Medical University of Silesia, Panewnicka 65, 40-760 Katowice, Poland.
J Clin Med. 2024 Sep 12;13(18):5407. doi: 10.3390/jcm13185407.
: The purpose of this study was to investigate the risk factors for glaucoma in patients with keratoconus following keratoplasty and to identify potential factors that could affect post-transplant complications. : A retrospective analysis was conducted on the medical records of 192 keratoconus patients who underwent keratoplasty. Data on treatment history, perioperative information, tissue bank data, postoperative regimens, complications, and infections were collected and analyzed. Statistical analysis was performed to identify risk factors associated with glaucoma and transplant complications. : There was a 41.6% incidence of glaucoma (high IOP) ( < 0.001), with the median time to glaucoma development being 314 ± 67 days post-transplant. A significant number of patients required surgical intervention, accounting for 48.05%. Our analysis revealed a 14% graft failure rate. On univariable Cox proportional hazard analysis, the following factors demonstrated statistically significant associations with the risk of glaucoma after transplantation: donor endothelial cell density, the use of a single continuous suture type, and the surgeon (performing the surgery). For many variables, the only factor that remained significant was the surgeon. Among the factors analyzed for risks of failure post-transplantation, significant associations were observed for the donor age, the time from harvest to transplant, and the surgeon. In the multivariable analysis, donor age emerged as a significant predictor of post-transplant complications. : Risk factors such as donor endothelial cell density, suture type, surgeon, host and donor size, and host gender were found to increase the risk of developing glaucoma post-keratoplasty. Surgeon type was identified as a significant risk factor, while donor age was predictive of post-transplant complications.
本研究的目的是调查圆锥角膜患者角膜移植术后青光眼的危险因素，并确定可能影响移植后并发症的潜在因素。
对192例行角膜移植术的圆锥角膜患者的病历进行回顾性分析。收集并分析治疗史、围手术期信息、组织库数据、术后方案、并发症和感染等数据。进行统计分析以确定与青光眼和移植并发症相关的危险因素。
青光眼（高眼压）的发生率为41.6%（P<0.001），青光眼发生的中位时间为移植后314±67天。相当数量的患者需要手术干预，占48.05%。我们的分析显示移植失败率为14%。单变量Cox比例风险分析显示，以下因素与移植后青光眼风险存在统计学显著关联：供体内皮细胞密度、使用单一连续缝合类型以及外科医生（进行手术者）。对于许多变量，唯一仍然显著的因素是外科医生。在分析的移植后失败风险因素中，供体年龄、从采集到移植的时间以及外科医生存在显著关联。多变量分析中，供体年龄成为移植后并发症的显著预测因素。
供体内皮细胞密度、缝合类型、外科医生、宿主和供体大小以及宿主性别等危险因素被发现会增加角膜移植术后发生青光眼的风险。外科医生类型被确定为显著危险因素，而供体年龄可预测移植后并发症。
