Survival Outcome and Prognostic Factors of Corneal Transplantation: A 15-Year Retrospective Cohort Study at King Chulalongkorn Memorial Hospital

Usanee Reinprayoon,1,2 Parinya Srihatrai,2 Vannarut Satitpitakul,1,2 Vilavun Puangsricharern,1,2 Thitima Wungcharoen,2 Ngamjit Kasetsuwan1,2 1Excellence Center of Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chul...

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Autores principales:	Reinprayoon U, Srihatrai P, Satitpitakul V, Puangsricharern V, Wungcharoen T, Kasetsuwan N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	keratoplasty thailand survival rate risk factor prognostic factor Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/22a49ea7576c4b49b119134e71f3a39b
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spelling	oai:doaj.org-article:22a49ea7576c4b49b119134e71f3a39b2021-12-02T17:13:58ZSurvival Outcome and Prognostic Factors of Corneal Transplantation: A 15-Year Retrospective Cohort Study at King Chulalongkorn Memorial Hospital1177-5483https://doaj.org/article/22a49ea7576c4b49b119134e71f3a39b2021-10-01T00:00:00Zhttps://www.dovepress.com/survival-outcome-and-prognostic-factors-of-corneal-transplantation-a-1-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Usanee Reinprayoon,1,2 Parinya Srihatrai,2 Vannarut Satitpitakul,1,2 Vilavun Puangsricharern,1,2 Thitima Wungcharoen,2 Ngamjit Kasetsuwan1,2 1Excellence Center of Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandCorrespondence: Usanee ReinprayoonExcellence Center of Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, ThailandTel +66 816186025Email usaneer@gmail.comPurpose: To evaluate long-term survival outcomes and determine the prognostic factors of corneal transplantation performed at a tertiary referral hospital in Thailand.Design: A 15-year retrospective cohort study.Materials and Methods: One corneal graft per patient was selected; graft failure was defined as graft opacity due to recurrent disease or endothelial cell dysfunction. Kaplan–Meier survival analysis was performed. Median time to failure was compared using the Log rank test. Prognostic factors were identified using the Cox proportional hazards model.Results: We enrolled 704 transplanted grafts. Surgical indications were optical (88.5%), therapeutic (10.2%), and tectonic (1.3%). The most common diagnoses were corneal opacity (25.3%), bullous keratopathy (15.8%), and regraft (14.8%). The overall survival rates at 1, 3, 5, and 10 years were 87.5%, 72.0%, 59.2%, and 41.7%, respectively. Univariate analysis identified age, primary diagnosis, graft size, pre-existing glaucoma, prior lens status, prior intraocular surgery, indication for surgery, donor endothelial cell density, and previous graft rejection as prognostic factors for graft failure. Multivariate analysis revealed three prognostic factors: primary diagnosis of perforation/peripheral ulceration/Mooren’s ulcer (hazard ratio [HR]=28.57; 95% confidence interval [CI], 6.32– 129.16; P< 0.001), active keratitis (HR=24.30; 95% CI, 5.88– 100.43; P< 0.001), regraft (HR=9.37; 95% CI, 2.27– 38.66; P=0.002), and pseudophakic/aphakic bullous keratopathy (HR=7.97; 95% CI, 1.93– 32.87; P=0.004); pre-existing glaucoma (HR=1.52; 95% CI, 1.13– 2.04; P=0.006); and previous graft rejection (HR=1.95; 95% CI, 1.54– 2.48; P< 0.001).Conclusion: Overall corneal graft survival rate was high in the first postoperative year and decreased after that. Primary diagnosis, pre-existing glaucoma, and previous graft rejection negatively influenced graft survival.Keywords: keratoplasty, Thailand, survival rate, risk factor, prognostic factorReinprayoon USrihatrai PSatitpitakul VPuangsricharern VWungcharoen TKasetsuwan NDove Medical Pressarticlekeratoplastythailandsurvival raterisk factorprognostic factorOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 4189-4199 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	keratoplasty thailand survival rate risk factor prognostic factor Ophthalmology RE1-994
spellingShingle	keratoplasty thailand survival rate risk factor prognostic factor Ophthalmology RE1-994 Reinprayoon U Srihatrai P Satitpitakul V Puangsricharern V Wungcharoen T Kasetsuwan N Survival Outcome and Prognostic Factors of Corneal Transplantation: A 15-Year Retrospective Cohort Study at King Chulalongkorn Memorial Hospital
description	Usanee Reinprayoon,1,2 Parinya Srihatrai,2 Vannarut Satitpitakul,1,2 Vilavun Puangsricharern,1,2 Thitima Wungcharoen,2 Ngamjit Kasetsuwan1,2 1Excellence Center of Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandCorrespondence: Usanee ReinprayoonExcellence Center of Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, ThailandTel +66 816186025Email usaneer@gmail.comPurpose: To evaluate long-term survival outcomes and determine the prognostic factors of corneal transplantation performed at a tertiary referral hospital in Thailand.Design: A 15-year retrospective cohort study.Materials and Methods: One corneal graft per patient was selected; graft failure was defined as graft opacity due to recurrent disease or endothelial cell dysfunction. Kaplan–Meier survival analysis was performed. Median time to failure was compared using the Log rank test. Prognostic factors were identified using the Cox proportional hazards model.Results: We enrolled 704 transplanted grafts. Surgical indications were optical (88.5%), therapeutic (10.2%), and tectonic (1.3%). The most common diagnoses were corneal opacity (25.3%), bullous keratopathy (15.8%), and regraft (14.8%). The overall survival rates at 1, 3, 5, and 10 years were 87.5%, 72.0%, 59.2%, and 41.7%, respectively. Univariate analysis identified age, primary diagnosis, graft size, pre-existing glaucoma, prior lens status, prior intraocular surgery, indication for surgery, donor endothelial cell density, and previous graft rejection as prognostic factors for graft failure. Multivariate analysis revealed three prognostic factors: primary diagnosis of perforation/peripheral ulceration/Mooren’s ulcer (hazard ratio [HR]=28.57; 95% confidence interval [CI], 6.32– 129.16; P< 0.001), active keratitis (HR=24.30; 95% CI, 5.88– 100.43; P< 0.001), regraft (HR=9.37; 95% CI, 2.27– 38.66; P=0.002), and pseudophakic/aphakic bullous keratopathy (HR=7.97; 95% CI, 1.93– 32.87; P=0.004); pre-existing glaucoma (HR=1.52; 95% CI, 1.13– 2.04; P=0.006); and previous graft rejection (HR=1.95; 95% CI, 1.54– 2.48; P< 0.001).Conclusion: Overall corneal graft survival rate was high in the first postoperative year and decreased after that. Primary diagnosis, pre-existing glaucoma, and previous graft rejection negatively influenced graft survival.Keywords: keratoplasty, Thailand, survival rate, risk factor, prognostic factor
format	article
author	Reinprayoon U Srihatrai P Satitpitakul V Puangsricharern V Wungcharoen T Kasetsuwan N
author_facet	Reinprayoon U Srihatrai P Satitpitakul V Puangsricharern V Wungcharoen T Kasetsuwan N
author_sort	Reinprayoon U
title	Survival Outcome and Prognostic Factors of Corneal Transplantation: A 15-Year Retrospective Cohort Study at King Chulalongkorn Memorial Hospital
title_short	Survival Outcome and Prognostic Factors of Corneal Transplantation: A 15-Year Retrospective Cohort Study at King Chulalongkorn Memorial Hospital
title_full	Survival Outcome and Prognostic Factors of Corneal Transplantation: A 15-Year Retrospective Cohort Study at King Chulalongkorn Memorial Hospital
title_fullStr	Survival Outcome and Prognostic Factors of Corneal Transplantation: A 15-Year Retrospective Cohort Study at King Chulalongkorn Memorial Hospital
title_full_unstemmed	Survival Outcome and Prognostic Factors of Corneal Transplantation: A 15-Year Retrospective Cohort Study at King Chulalongkorn Memorial Hospital
title_sort	survival outcome and prognostic factors of corneal transplantation: a 15-year retrospective cohort study at king chulalongkorn memorial hospital
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/22a49ea7576c4b49b119134e71f3a39b
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Survival Outcome and Prognostic Factors of Corneal Transplantation: A 15-Year Retrospective Cohort Study at King Chulalongkorn Memorial Hospital

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