Lymphatic corneal neovascularisation affects graft survival in high-risk corneal transplantation
Objectives Corneal neovascularisation (CoNV) is a major risk factor for corneal allograft rejection and failure. This study assessed the impact of preoperative lymphatic and haematic vascularisation of the graft bed on graft survival in a clinical setting.Methods and analysis This retrospective stud...
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BMJ Publishing Group
2025-03-01
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| Series: | BMJ Open Ophthalmology |
| Online Access: | https://bmjophth.bmj.com/content/10/1/e001961.full |
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| author | Bernhard Steger Matus Rehak Christof Seifarth Christoph Palme Gertrud Haas Nadja Franz Alexander Franchi Victoria Stöckl |
| author_facet | Bernhard Steger Matus Rehak Christof Seifarth Christoph Palme Gertrud Haas Nadja Franz Alexander Franchi Victoria Stöckl |
| author_sort | Bernhard Steger |
| collection | DOAJ |
| description | Objectives Corneal neovascularisation (CoNV) is a major risk factor for corneal allograft rejection and failure. This study assessed the impact of preoperative lymphatic and haematic vascularisation of the graft bed on graft survival in a clinical setting.Methods and analysis This retrospective study included patients with histologically confirmed CoNV (positive staining for CD-31) who underwent penetrating keratoplasty (PK) between 2008 and 2023 at the Medical University of Innsbruck, Austria. Cases were divided into two groups depending on the presence or absence of lymphatic CoNV (podoplanin staining). Follow-up was 2 years or until graft failure. Outcome parameters included the risk of graft failure and leakage patterns in a subgroup with preoperative indocyanine green (ICG) angiography.Results Of 17 included patients, lymphatic CoNV was identified in the excised corneal buttons of 10 cases (group 1). Seven cases stained only for haematic CoNV (group 2). Group 1 had a shorter age of CoNV (0.6±0.4 vs 2.3±0.8 years, p<0.001) and a higher rate of graft failure (6/10 vs 0/7, p=0.005). Lymphatic CoNV was only present in the age of CoNV less than 12 months. ICG leakage was associated with a younger age of CoNV (p=0.0338), corresponding to the presence of lymphatic CoNV at a younger age of CoNV.Conclusion Lymphatic CoNV in haemvascularised corneal stromal beds increases the risk of graft failure within 2 years. Lymphatic CoNV regression occurs within the first year of an inciting event. This time period or the presence of ICG dye leakage indicates a very high risk for corneal transplantation. |
| format | Article |
| id | doaj-art-7e8b12e9790048b79e7c4cd8bacc743e |
| institution | DOAJ |
| issn | 2397-3269 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Ophthalmology |
| spelling | doaj-art-7e8b12e9790048b79e7c4cd8bacc743e2025-08-20T02:50:27ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692025-03-0110110.1136/bmjophth-2024-001961Lymphatic corneal neovascularisation affects graft survival in high-risk corneal transplantationBernhard Steger0Matus Rehak1Christof Seifarth2Christoph Palme3Gertrud Haas4Nadja Franz5Alexander Franchi6Victoria Stöckl7Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Tirol, AustriaDepartment of Ophthalmology, Medical University of Innsbruck, Innsbruck, Tirol, AustriaOphthalmology, Medizinische Universität Innsbruck, Innsbruck, Tyrol, AustriaDepartment of Ophthalmology and Optometry, Medical University of Innsbruck, Innsbruck, Tirol, AustriaDepartment of Ophthalmology and Optometry, Medical University of Innsbruck, Innsbruck, Tirol, AustriaDepartment of Ophthalmology, Medical University of Innsbruck, Innsbruck, Tirol, AustriaOphthalmology, Medizinische Universität Innsbruck, Innsbruck, Tyrol, AustriaDepartment of Ophthalmology, Medical University of Innsbruck, Innsbruck, Tirol, AustriaObjectives Corneal neovascularisation (CoNV) is a major risk factor for corneal allograft rejection and failure. This study assessed the impact of preoperative lymphatic and haematic vascularisation of the graft bed on graft survival in a clinical setting.Methods and analysis This retrospective study included patients with histologically confirmed CoNV (positive staining for CD-31) who underwent penetrating keratoplasty (PK) between 2008 and 2023 at the Medical University of Innsbruck, Austria. Cases were divided into two groups depending on the presence or absence of lymphatic CoNV (podoplanin staining). Follow-up was 2 years or until graft failure. Outcome parameters included the risk of graft failure and leakage patterns in a subgroup with preoperative indocyanine green (ICG) angiography.Results Of 17 included patients, lymphatic CoNV was identified in the excised corneal buttons of 10 cases (group 1). Seven cases stained only for haematic CoNV (group 2). Group 1 had a shorter age of CoNV (0.6±0.4 vs 2.3±0.8 years, p<0.001) and a higher rate of graft failure (6/10 vs 0/7, p=0.005). Lymphatic CoNV was only present in the age of CoNV less than 12 months. ICG leakage was associated with a younger age of CoNV (p=0.0338), corresponding to the presence of lymphatic CoNV at a younger age of CoNV.Conclusion Lymphatic CoNV in haemvascularised corneal stromal beds increases the risk of graft failure within 2 years. Lymphatic CoNV regression occurs within the first year of an inciting event. This time period or the presence of ICG dye leakage indicates a very high risk for corneal transplantation.https://bmjophth.bmj.com/content/10/1/e001961.full |
| spellingShingle | Bernhard Steger Matus Rehak Christof Seifarth Christoph Palme Gertrud Haas Nadja Franz Alexander Franchi Victoria Stöckl Lymphatic corneal neovascularisation affects graft survival in high-risk corneal transplantation BMJ Open Ophthalmology |
| title | Lymphatic corneal neovascularisation affects graft survival in high-risk corneal transplantation |
| title_full | Lymphatic corneal neovascularisation affects graft survival in high-risk corneal transplantation |
| title_fullStr | Lymphatic corneal neovascularisation affects graft survival in high-risk corneal transplantation |
| title_full_unstemmed | Lymphatic corneal neovascularisation affects graft survival in high-risk corneal transplantation |
| title_short | Lymphatic corneal neovascularisation affects graft survival in high-risk corneal transplantation |
| title_sort | lymphatic corneal neovascularisation affects graft survival in high risk corneal transplantation |
| url | https://bmjophth.bmj.com/content/10/1/e001961.full |
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