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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2008, Number 5

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Rev Mex Oftalmol 2008; 82 (5)

Factores asociados con rechazo a trasplante de córnea, por grupos de pronóstico

Sánchez CM, Olivares MOE, Lima GV, Razo-Blanco HDM, Pérez TC

Language: Spanish
References: 14
Page: 277-280
PDF size: 25.82 Kb.


ABSTRACT

Purpose: To identify the risk factors with higher association with rejection, after penetrating keratoplasty in eyes with different prognosis.
Material and methods: Observational, longitudinal, retrospective, analytic and open label study, from January 2003 to November 2006. We included eyes that underwent penetrating keratoplasty for any corneal disease, of any age and gender, and with at least 1 year follow up. According to the diagnosis each eye was assigned to one of four groups of prognosis. The clinical features considered of risk for rejection were identified in eyes with and without it, and the difference between proportions was analyzed by rates of χ2 and odds ratio.
Results: 110 eyes of patients aged 4-90: 42 eyes of group 1 (38.2%), 52 of group 2 (47.3%), 9 of group 3 (8.2%) and 7 of group 4 (6.4%); 57 eyes had immunologic rejection (54.1%). Only vascularization was more frequently associated with rejection (p=0.01, odds ratio 9.75); the rate of rejection did not differ statistically between groups (p›0.05).
Conclusions: The risk factors associated significantly with corneal rejection were anatomical, rather than etiologic; standardization of preoperative evaluation of neovascularization is necessary to identify its usefulness as predicting factor.


REFERENCES

  1. Fasolo A, Frigo AC, Böhm E, Genisi C, Rama P, Spadea L y cols. The CORTES Study: Corneal Transplant Indications and Graft Survival in an Italian Cohort of Patients. Cornea 2006; 25: 507-515.

  2. Niederkorn JY. Ocular Immune privilege: Nature’s strategy for preserving vision. Science and Medicine 2003; 9:320-33.

  3. Fink N, Stark WJ, Maguire MG, Stulting D, Meyer R y cols. Effectiveness of histocompatibility matching in high-risk corneal transplantation: a summary of results from the Collabo rative Corneal Transplantation Studies. Cesk Oftalmol 1994; 50(1):3-12.

  4. Polack FM. Clinical and pathological aspects of the corneal graft reaction. Trans Am Acad Ophthalmol 1973; 77:418-432.

  5. Inoue K, Amano S, Oshika T, Tsuru T. Risk factors for corneal graft failure and rejection in penetrating keratoplasty. Acta Ophthalmol Scand 2001; 79:251-255.

  6. Arentsen JJ: Corneal transplant allograft reaction: possible predisposing factors. Trans Am Ophthalmol Soc 1983; 81:361-402.

  7. Koay PY, Lee WH, Figueiredo FC. Opinions on risk factors and management of corneal graft rejection in the United Kingdom. Cornea 2005; 24:292-296.

  8. Khodadoust AA. The allograft rejection: The leading cause of late failure of clinical corneal graft. En: Porter R, Knight J (eds). Corneal graft failure. Ciba Found Symp 1973; 19:151.

  9. Eye Bank Association of America Annual Report, 1993.

  10. Batchelor JR, Casey TA, Werb A, Gibbs DC, Prasad SS, Lloyd DF y cols. HLA matching and corneal grafting. Lancet 1976; 1:551-554.

  11. Boisjoly HM, Bernard PM, Dubé I, Laughrea PA, Bazin R, Bernier J. Effect of factors unrelated to tissue matching on corneal transplant endothelial rejection. Am J Ophthalmol 1989; 107:647-654.

  12. The Collaborative Corneal Transplantation Research Group. Design and methods of the collaborative corneal transplantation studies. Cornea 1993; 12:93-103.

  13. Gillette TE, Chandler JW, Greiner JV. Langerhans cells of the ocular surface. Ophthalmology 1982: 89:700-711.

  14. Ross J, He YG, Pidherney M, Mellon J, Niederkorn JY. The differential effects of donor versus host Langerhans cells in the rejection of MHC-matched corneal allografts. Transplantation 1991; 52:857-861.




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