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. 1997 Aug;81(8):631-6.
doi: 10.1136/bjo.81.8.631.

Conclusions of the corneal transplant follow up study. Collaborating Surgeons

A Vail  1 , S M Gore, B A Bradley, D L Easty, C A Rogers, W J Armitage
Affiliations

Conclusions of the corneal transplant follow up study. Collaborating Surgeons

A Vail et al. Br J Ophthalmol. 1997 Aug.

Abstract

Aim: On the basis of finalised data from the Corneal Transplant Follow up Study to identify and quantify factors influencing corneal graft outcome in terms of graft survival, rejection, visual acuity, and astigmatism.

Methods: Multifactorial analysis of 2777 grafts registered by the UK Transplant Support Service from July 1987 to June 1991.

Results: Several recipient factors influencing graft survival, rejection, and visual acuity were identified, but no donor factors. Of the operative factors amenable to change, mixed suturing was associated with reduced graft survival, and larger grafts with increased risk of rejection but better visual acuity when surviving. There was increased risk of rejection with poor matching at HLA class I antigens, but mismatched HLA-DR grafts suffered less rejection than those with zero HLA-DR mismatches. Recipient age below 10 years was associated with increased risk of both rejection and graft failure. However, whereas increasing age above 10 years was not associated with differential graft survival, it was significantly associated with decreasing risk of rejection.

Conclusions: While confirming possible benefits of HLA-A and B matching, the expense and delay involved in awaiting matched HLA-DR tissue is unlikely to be justified. Other donor factors are unrelated to graft outcome following screening of tissue by eye banks. The highest rates of graft failure and rejection happen in the early postoperative period, and factors influencing visual outcome are also apparent at this stage.

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Figures

Figure 1
Figure 1
Graft survival and 75 day hazard rates.
Figure 2
Figure 2
Rejection free graft survival and 75 day hazard rates.
Figure 3
Figure 3
Influence of HLA mismatching on rejection free graft survival, adjusted for other factors.
Figure 4
Figure 4
Distributions of corrected visual acuity.
Figure 5
Figure 5
Distributions of astigmatism.
See this image and copyright information in PMC

Comment in

  • Evaluation of corneal transplantation.
    Coster DJ. Coster DJ. Br J Ophthalmol. 1997 Aug;81(8):618-9. doi: 10.1136/bjo.81.8.618. Br J Ophthalmol. 1997. PMID: 9349143 Free PMC article. No abstract available.
  • Corneal transplantation: how successful are we?
    Armitage WJ, Crewe JM, Tullo AB. Armitage WJ, et al. Br J Ophthalmol. 2001 Jan;85(1):122. doi: 10.1136/bjo.85.1.121c. Br J Ophthalmol. 2001. PMID: 11133728 Free PMC article. No abstract available.

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