Cornea · 2011
Risk factors for graft failure after penetrating keratoplasty: 5-year follow-up from the corneal transplant epidemiological study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Fasolo Adriano, Capuzzo Cristina, Fornea Michela, Franch Antonella, Birattari Federica, Carito Giuseppe, Cucco Flavio, Prosdocimo Giovanni, Sala Michele, Delle Noci Nicola, Primavera Vito, Frigo Anna Chiara, Grigoletto Francesco, Ponzin Diego, CORTES Study Group
Аннотация
PURPOSE: To evaluate corneal graft survival over a 5-year period and to investigate whether factors related to the donor, eye bank practices, the recipient, surgery, and postoperative course influenced the outcome.
METHODS: Nine hundred ninety-eight patients were randomly selected and monitored in the subsequent 3 years from a cohort of 4500 recipients who underwent penetrating keratoplasty between 2001 and 2004. Cox univariate regression analysis was used to select variables to be included in a multivariate Cox proportional hazards model with a backward selection procedure to identify potential risk factors for graft failure. Graft survival curves were obtained from Kaplan-Meier estimates.
RESULTS: Ectasia/thinning was the most common indication (49.1%), followed by regraft (16.1%) and pseudophakic corneal edema (PCE) (9.4%). The overall rate of graft failure was 10.7% with 6 cases of primary graft failure. Adverse reactions and complications (other than graft failure) were reported in 2.7% of patients in the first postoperative week and in 22.8% during the full follow-up period. The probability of 5-year survival was 83.0%, best in eyes with ectasia/thinning (96.0%) and less favorable in PCE (67.0%) and regraft (64.0%). Multivariate analyses showed the following variables to be linked to an increased risk of graft failure: regraft for any reason, all clinical indication except PCE, history of ocular inflammation/infection, pseudophakic/aphakic eye, vitrectomy, graft Descemet folds, adverse reactions/complications, and surgeons' low caseload.
CONCLUSIONS: Penetrating keratoplasty shows an overall positive prognosis in the long-term. However, the probability of graft survival is largely dependent on the preoperative clinical condition and the lack of complications during follow-up.
METHODS: Nine hundred ninety-eight patients were randomly selected and monitored in the subsequent 3 years from a cohort of 4500 recipients who underwent penetrating keratoplasty between 2001 and 2004. Cox univariate regression analysis was used to select variables to be included in a multivariate Cox proportional hazards model with a backward selection procedure to identify potential risk factors for graft failure. Graft survival curves were obtained from Kaplan-Meier estimates.
RESULTS: Ectasia/thinning was the most common indication (49.1%), followed by regraft (16.1%) and pseudophakic corneal edema (PCE) (9.4%). The overall rate of graft failure was 10.7% with 6 cases of primary graft failure. Adverse reactions and complications (other than graft failure) were reported in 2.7% of patients in the first postoperative week and in 22.8% during the full follow-up period. The probability of 5-year survival was 83.0%, best in eyes with ectasia/thinning (96.0%) and less favorable in PCE (67.0%) and regraft (64.0%). Multivariate analyses showed the following variables to be linked to an increased risk of graft failure: regraft for any reason, all clinical indication except PCE, history of ocular inflammation/infection, pseudophakic/aphakic eye, vitrectomy, graft Descemet folds, adverse reactions/complications, and surgeons' low caseload.
CONCLUSIONS: Penetrating keratoplasty shows an overall positive prognosis in the long-term. However, the probability of graft survival is largely dependent on the preoperative clinical condition and the lack of complications during follow-up.