Abstract
Purpose Corneal regrafts sometimes needed to restore the transparency after graft failure. The aim of the study is five years epidemiologic and histopathological evaluation of corneal regrafts. Methods In this cross-sectional study, all corneal regrafts during 5 years (2012–2016) were assessed in the Khalili Ophthalmology Center at Shiraz city. Demographic data including age, area of residence, primary disease, type of graft, cause of regraft, interval between primary and subsequent grafts (IPSG), associated eye diseases or surgeries, and systemic diseases were recorded. Also, microscopic findings of corneas were reviewed. Results Among a total of 1190 corneal grafts, 76 of them (6.38%) were regrafts. The most common type of grafting was penetrating keratoplasty (PK). The shortest IPSG was observed in fungal keratitis. Main causes of graft failure were endothelial dysfunction, infection, immunologic rejection, technical problems, and recurrence of primary disease, respectively. The most common histopathological finding in failed grafts was severe endothelial cell loss (89.8%). Also, more than half and one-third of cases had Descemet membrane changes and stromal ingrowth, respectively. Conclusion Endothelial cell loss was the major cause of failure in our study. Also, recurrence rate in infective cases, especially fungal keratitis, was very high. Considerable presence of histopathological changes such as doubling of Descemet membrane and retrocorneal fibrous ingrowth need further investigations. Perhaps, modification in techniques of corneal grafting and assessment of donor tissue and recipient bed along with any need for longer medical treatment are the basis for future studies in order to increase graft survival.
Highlights
Corneal transplant survival depends on many factors such as the quality of the donor tissue, technique of the surgery, postoperative care, and rapid controlling of the consequences occurring afterward such as rejection or infection [1,2,3]
E purpose of this study is to evaluate the epidemiologic and histopathological findings of corneal regrafting conducted during 5 years (2012–2016) at Khalili Hospital, Shiraz, as the major referral center in southern Iran in order to find the main risk factors of corneal regraft and highlight the need for better understanding of pathophysiology of graft failures based on histologic findings
In the present cross-sectional study, epidemiological and histopathological characteristics of all corneal regraft cases at Khalili Hospital, Shiraz, Iran, were evaluated during a 5-year period (2012–2016). e research project has been approved by Ethics Committee of Shiraz University of Medical Sciences with number 4982–94
Summary
Five Years Pathological Evaluation of Corneal Regrafts: A Study from Southern Iran. Corneal regrafts sometimes needed to restore the transparency after graft failure. E aim of the study is five years epidemiologic and histopathological evaluation of corneal regrafts. In this cross-sectional study, all corneal regrafts during 5 years (2012–2016) were assessed in the Khalili Ophthalmology Center at Shiraz city. Main causes of graft failure were endothelial dysfunction, infection, immunologic rejection, technical problems, and recurrence of primary disease, respectively. E most common histopathological finding in failed grafts was severe endothelial cell loss (89.8%). Endothelial cell loss was the major cause of failure in our study. Considerable presence of histopathological changes such as doubling of Descemet membrane and retrocorneal fibrous ingrowth need further investigations. Modification in techniques of corneal grafting and assessment of donor tissue and recipient bed along with any need for longer medical treatment are the basis for future studies in order to increase graft survival
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