dc.contributor.author |
Lu, Lucy M |
|
dc.contributor.author |
Boyle, Alexander B |
|
dc.contributor.author |
Niederer, Rachael L |
|
dc.contributor.author |
Brookes, Nigel H |
|
dc.contributor.author |
McGhee, Charles NJ |
|
dc.contributor.author |
Patel, Dipika V |
|
dc.coverage.spatial |
Australia |
|
dc.date.accessioned |
2022-06-22T22:05:44Z |
|
dc.date.available |
2022-06-22T22:05:44Z |
|
dc.date.issued |
2019-11 |
|
dc.identifier.citation |
(2019). Clinical and Experimental Ophthalmology, 47(8), 987-994. |
|
dc.identifier.issn |
1442-6404 |
|
dc.identifier.uri |
https://hdl.handle.net/2292/60107 |
|
dc.description.abstract |
IMPORTANCE:In New Zealand, repeat keratoplasty has become the second leading indication for corneal transplantation. BACKGROUND:To report the indications, outcomes and survival of repeat keratoplasty and evaluate the risk factors for graft failure. DESIGN:Retrospective study in a public corneal service. PARTICIPANTS:Two hundred nineteen patients undergoing 279 repeat keratoplasty procedures during 1991-2017. METHODS:The New Zealand National Eye Bank prospectively collects data on all corneal transplants. This was utilized to identify patients undergoing repeat keratoplasty in Auckland. Clinical records were retrospectively reviewed. MAIN OUTCOME MEASURES:Graft survival and visual outcome. RESULTS:The repeat keratoplasty technique was penetrating keratoplasty (PK) in 242 cases (86.7%) and endothelial keratoplasty in 37 (13.3%). The most common primary indication was keratoconus (46.6%). The most common indication for repeat keratoplasty was endothelial decompensation (37.6%). For PK performed as a repeat keratoplasty, the median survival in years was 12.0 for first, 3.5 for second and 2.3 for third repeat keratoplasty. Keratoconus had the longest graft survival (median 13.0 years). In surviving grafts, median visual acuity was 6/15 at 1 year and 6/12 at 2 years. On multivariate analysis, regraft number (P = .022), non-European ethnicity (P = .007), concurrent surgical procedure (P < .0005), lower donor endothelial density (P = .028), previous glaucoma surgery (P < .0005), postoperative raised intraocular pressure (P = .001) and graft rejection (P = .032) were associated with keratoplasty failure. CONCLUSIONS AND RELEVANCE:Repeat keratoplasty survival is affected by multiple interacting factors and prognosis worsens with each subsequent regraft. These results will help guide clinicians in addressing patients' individual risk factors when embarking on repeat corneal transplant surgery. |
|
dc.format.medium |
Print-Electronic |
|
dc.language |
eng |
|
dc.publisher |
Wiley |
|
dc.relation.ispartofseries |
Clinical & experimental ophthalmology |
|
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
|
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
|
dc.subject |
Humans |
|
dc.subject |
Keratoconus |
|
dc.subject |
Postoperative Complications |
|
dc.subject |
Keratoplasty, Penetrating |
|
dc.subject |
Reoperation |
|
dc.subject |
Risk Factors |
|
dc.subject |
Retrospective Studies |
|
dc.subject |
Graft Rejection |
|
dc.subject |
Graft Survival |
|
dc.subject |
Visual Acuity |
|
dc.subject |
Time Factors |
|
dc.subject |
Adult |
|
dc.subject |
Aged |
|
dc.subject |
Middle Aged |
|
dc.subject |
New Zealand |
|
dc.subject |
Female |
|
dc.subject |
Male |
|
dc.subject |
Descemet Stripping Endothelial Keratoplasty |
|
dc.subject |
corneal transplantation |
|
dc.subject |
endothelial keratoplasty |
|
dc.subject |
penetrating keratoplasty |
|
dc.subject |
repeat keratoplasty |
|
dc.subject |
Rare Diseases |
|
dc.subject |
Eye Disease and Disorders of Vision |
|
dc.subject |
Transplantation |
|
dc.subject |
Clinical Research |
|
dc.subject |
6.4 Surgery |
|
dc.subject |
Eye |
|
dc.subject |
Science & Technology |
|
dc.subject |
Life Sciences & Biomedicine |
|
dc.subject |
Ophthalmology |
|
dc.subject |
FAILED PENETRATING KERATOPLASTY |
|
dc.subject |
TERTIARY REFERRAL CENTER |
|
dc.subject |
CHANGING INDICATIONS |
|
dc.subject |
SURGICAL TECHNIQUES |
|
dc.subject |
TRENDS |
|
dc.subject |
GRAFT |
|
dc.subject |
CANADA |
|
dc.subject |
1113 Opthalmology and Optometry |
|
dc.subject |
Clinical |
|
dc.subject |
Clinical Medicine and Science |
|
dc.subject |
1103 Clinical Sciences |
|
dc.subject |
1117 Public Health and Health Services |
|
dc.title |
Repeat corneal transplantation in Auckland, New Zealand: Indications, visual outcomes and risk factors for repeat keratoplasty failure. |
|
dc.type |
Journal Article |
|
dc.identifier.doi |
10.1111/ceo.13581 |
|
pubs.issue |
8 |
|
pubs.begin-page |
987 |
|
pubs.volume |
47 |
|
dc.date.updated |
2022-05-10T02:24:54Z |
|
dc.rights.holder |
Copyright: The author |
en |
dc.identifier.pmid |
31268240 (pubmed) |
|
pubs.author-url |
https://www.ncbi.nlm.nih.gov/pubmed/31268240 |
|
pubs.end-page |
994 |
|
pubs.publication-status |
Published |
|
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Journal Article |
|
pubs.elements-id |
776348 |
|
pubs.org-id |
Medical and Health Sciences |
|
pubs.org-id |
School of Medicine |
|
pubs.org-id |
Ophthalmology Department |
|
dc.identifier.eissn |
1442-9071 |
|
pubs.record-created-at-source-date |
2022-05-10 |
|
pubs.online-publication-date |
2019-07-22 |
|