Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study
Purpose. To analyze the indications and surgical procedures for repeat keratoplasty in eastern China from 2008 to 2019. Methods. This retrospective descriptive study included 418 eyes of 411 patients who underwent no less than 2 keratoplasties at the Eye, Ear, Nose and Throat Hospital of Fudan Unive...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2021/5514004 |
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| author | Xichen Wan Wang Yao Songjiao Zhao Jianjiang Xu Qihua Le |
| author_facet | Xichen Wan Wang Yao Songjiao Zhao Jianjiang Xu Qihua Le |
| author_sort | Xichen Wan |
| collection | DOAJ |
| description | Purpose. To analyze the indications and surgical procedures for repeat keratoplasty in eastern China from 2008 to 2019. Methods. This retrospective descriptive study included 418 eyes of 411 patients who underwent no less than 2 keratoplasties at the Eye, Ear, Nose and Throat Hospital of Fudan University from 2008 to 2019. Medical charts were reviewed. The primary indications for repeat keratoplasty, the reasons for regrafting, and the surgical techniques used in the treatment were collected and analyzed. Results. Among 418 eyes, 337 eyes (80.6%) had one repeat keratoplasty, and 81 eyes (19.4%) had multiple repeat keratoplasties (≥2 repeat keratoplasties). The median interval between the initial keratoplasty and the first repeat keratoplasty was 25 months, and that between two keratoplasties after the first repeat keratoplasty was 27.5 months. Infectious keratitis was the leading primary indication for single repeat keratoplasty (80 cases, 23.7%) and multiple repeat keratoplasties (19 cases, 23.5%). The second most common primary indication was bullous keratopathy for single repeat keratoplasty (49 eyes, 14.5%) and chemical injury for multiple repeat keratoplasties (14 eyes, 17.3%). The main reason for regrafting was allograft rejection (262 cases, 49.3%), followed by endothelial dysfunction (92 cases, 17.3%), and for vision improvement after tectonic keratoplasty (60 cases, 11.3%). Penetrating keratoplasty (PKP) was the major technique used in repeat keratoplasty (447 cases, 84.2%). However, Descemet stripping endothelial keratoplasty was more frequently used than PKP (72.4% vs. 27.6%, P<0.001) in the treatment of failed endothelial keratoplasty. Conclusion. Infectious keratitis was still the leading cause of repeat keratoplasty in eastern China. Although PKP remains the major technique of repeat keratoplasty, the application of customized lamellar keratoplasty has greatly expanded in the last decade. Cautious selection of indications, surgical techniques, and timing for surgery is crucial for a good prognosis after repeat keratoplasty. |
| format | Article |
| id | doaj-art-544bac2f9ba9482d9bba315deadfc3f9 |
| institution | DOAJ |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-544bac2f9ba9482d9bba315deadfc3f92025-08-20T03:20:15ZengWileyJournal of Ophthalmology2090-004X2090-00582021-01-01202110.1155/2021/55140045514004Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year StudyXichen Wan0Wang Yao1Songjiao Zhao2Jianjiang Xu3Qihua Le4Department of Ophthalmology Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, ChinaDepartment of Ophthalmology Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, ChinaDepartment of Ophthalmology Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, ChinaDepartment of Ophthalmology Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, ChinaDepartment of Ophthalmology Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, ChinaPurpose. To analyze the indications and surgical procedures for repeat keratoplasty in eastern China from 2008 to 2019. Methods. This retrospective descriptive study included 418 eyes of 411 patients who underwent no less than 2 keratoplasties at the Eye, Ear, Nose and Throat Hospital of Fudan University from 2008 to 2019. Medical charts were reviewed. The primary indications for repeat keratoplasty, the reasons for regrafting, and the surgical techniques used in the treatment were collected and analyzed. Results. Among 418 eyes, 337 eyes (80.6%) had one repeat keratoplasty, and 81 eyes (19.4%) had multiple repeat keratoplasties (≥2 repeat keratoplasties). The median interval between the initial keratoplasty and the first repeat keratoplasty was 25 months, and that between two keratoplasties after the first repeat keratoplasty was 27.5 months. Infectious keratitis was the leading primary indication for single repeat keratoplasty (80 cases, 23.7%) and multiple repeat keratoplasties (19 cases, 23.5%). The second most common primary indication was bullous keratopathy for single repeat keratoplasty (49 eyes, 14.5%) and chemical injury for multiple repeat keratoplasties (14 eyes, 17.3%). The main reason for regrafting was allograft rejection (262 cases, 49.3%), followed by endothelial dysfunction (92 cases, 17.3%), and for vision improvement after tectonic keratoplasty (60 cases, 11.3%). Penetrating keratoplasty (PKP) was the major technique used in repeat keratoplasty (447 cases, 84.2%). However, Descemet stripping endothelial keratoplasty was more frequently used than PKP (72.4% vs. 27.6%, P<0.001) in the treatment of failed endothelial keratoplasty. Conclusion. Infectious keratitis was still the leading cause of repeat keratoplasty in eastern China. Although PKP remains the major technique of repeat keratoplasty, the application of customized lamellar keratoplasty has greatly expanded in the last decade. Cautious selection of indications, surgical techniques, and timing for surgery is crucial for a good prognosis after repeat keratoplasty.http://dx.doi.org/10.1155/2021/5514004 |
| spellingShingle | Xichen Wan Wang Yao Songjiao Zhao Jianjiang Xu Qihua Le Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study Journal of Ophthalmology |
| title | Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study |
| title_full | Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study |
| title_fullStr | Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study |
| title_full_unstemmed | Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study |
| title_short | Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study |
| title_sort | indications and surgical techniques for repeat corneal transplantation in eastern china a twelve year study |
| url | http://dx.doi.org/10.1155/2021/5514004 |
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