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. 2023 Feb;31(2):257-262.
doi: 10.1080/09273948.2021.2024860. Epub 2022 Jan 20.

Prior Contralateral Penetrating Keratoplasty Is a Risk Factor for Second Eye Graft Rejection

Eric J Shiuey  1 , Qiang Zhang  1   2 , Christopher J Rapuano  1   3 , Brandon D Ayres  1   3 , Kristin M Hammersmith  1   3 , Parveen K Nagra  1   3 , Zeba A Syed  1   3
Affiliations

Prior Contralateral Penetrating Keratoplasty Is a Risk Factor for Second Eye Graft Rejection

Eric J Shiuey et al. Ocul Immunol Inflamm. 2023 Feb.

Abstract

Aims: To determine whether prior penetrating keratoplasty (PK) in the contralateral eye increases risk of second eye PK graft rejection.

Methods: Cohort study of 593 consecutive PKs in transplant-naïve eyes (500 unilateral cases, 93 second eyes). Outcomes were compared between PKs performed in eyes with versus without a history of prior contralateral eye PK. Risks of rejection and failure were estimated using Cox proportional hazards models.

Results: Mean age was 53.7 ± 23.3 years; average follow-up was 4.00 ± 2.87 years. Rejection occurred in 211 (35.6%) grafts. The incidence of rejection was 34.0% in unilateral cases and 44.1% in second eyes with PK in the contralateral eye. Prior contralateral PK was a significant risk factor for graft rejection (HR = 1.42, 95% CI 1.01-2.01, p = .045).

Conclusion: Contralateral PK is associated with increased risk of second eye graft rejection. Loss of ocular immune privilege is a possible mechanism.

Keywords: Penetrating keratoplasty; cornea; graft rejection; immunology; inflammation.

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