Risk Factors for Graft Failure After DSAEK
Narrative Responses:
Purpose
As we have observed patients with a post DSAEK rise in IOP we were interested to see if this correlated with graft failure. Preliminary reports on DSAEK indicate that an acute post-operative rise in IOP does not appear to influence graft survival; however, this warrants further study.
Methods
In this study, 117 DSAEK cases performed at the Ivey Eye Institute were retrospectively reviewed. This study was conducted in accordance with the Declaration of Helsinki and Western University’s Health Sciences Research Ethics Board. Only the first graft received by each patient was analyzed. Corneal graft failure was defined as an irreversible loss of optical clarity. Graft survival was calculated using Kaplan–Meier survival analysis. Post operative rise in IOP (>21mmHg) and the indication for DSAEK (Fuchs corneal dystrophy or pseudophakic bullous keratopathy) were analyzed as potential risk factors for graft failure by Cox proportional hazards analysis.
Results
Overall graft survival was 88.5% with all graft failures occurring within the first year. A post operative rise in IOP and indication for DSAEK were not significant risk factors (P>0.05) for graft failure in Cox proportional hazards analysis.
Conclusion
Patients with a medically managed rise in IOP following DSAEK were not at significantly higher risk for graft failure, nor was the initial indication for grafting a risk factor for graft failure. This study adds to the growing body of literature outlining risk factors for graft failure in DSAEK.