IMPACT OF RECIPIENT PREOPERATIVE FACTORS ON CORNEAL GRAFT REJECTION AFTER PENETRATING KERATOPLASTY

Our aim was to assess the influence of recipient factors on graft rejection after penetrating keratoplasty. A retrospective chart review was conducted on all patients who underwent a penetrating keratoplasty from 2005 to 2010. Data on patient demographics, keratoplasty indications and general and local factors of the recipient were collected and analyzed for probable influence on the development of a rejection episode by Cox regression analysis. The study included 141 keratoplasties. At the last follow-up about two thirds of the grafts were clear (64.7%). At least one rejection episode developed in 49 cases (34.8%). Patients with bullous keratopathy or leucoma had a significantly higher risk for graft rejection than patients with keratoconus or stromal dystrophy. With the increasing extent of corneal vascularization, a concomitant rise in the threat of rejection was noted. Female patients were at higher risk than males (hazard ratio 1.84). Multivariate proportional hazard modelling revealed indication for surgery and anterior chamber status to be independent risk factors. Recipient status has a notable influence on the risk of corneal graft rejection. The preoperative diagnosis and the condition of the anterior chamber have the most significant impact on our patient group.