Graft Reepithelialization after Penetrating Keratoplasty Using Organ-Cultured Donor Tissue

Abstract

To analyze graft reepithelialization after penetrating keratoplasty using organ-cultured donor tissue. Retrospective observational cohort study. One thousand one hundred thirty-eight consecutive penetrating keratoplasties (1003 patients) performed between 1992 and 2004 were analyzed, and 1003 were included (1 graft per patient was included). Slit-lamp examination after fluorescein staining. Graft reepithelialization time was recorded. The average graft reepithelialization time was 4.6+/-13.2 days (range, 1-210 days; median, 2.5 days). Complete corneal epithelial healing was obtained in 1 day in 28.5% of patients, in 3 days in 65.8%, in 7 days in 93.6%, and in 14 days in 97.0%. Postoperative chronic epithelial defects occurred in 3.0% of patients. In univariate analysis, death-to-storage time, storage time, deswelling time, rejection risk, trephination size, suture method, use of dexamethasone ointment during surgery, use of sodium hyaluronate during surgery, and use of high postoperative steroid regimen significantly influenced the graft reepithelialization time (P<0.05). In multiple regression, only the rejection risk (beta = 0.07; P = 0.045), use of sodium hyaluronate at the end of surgery (beta = -0.17; P = 0.001), and steroid regimen (beta = 0.09; P = 0.022) significantly influenced the graft reepithelialization time. The use of sodium hyaluronate at the end of surgery to coat the ocular surface shortened graft reepithelialization time after penetrating keratoplasty using organ-cultured donor tissue. Graft reepithelialization time was longer in high-risk recipients, and it increased with high dexamethasone eyedrops regimen.