Document Detail

Corneal thickness as a predictor of corneal transplant outcome.
MedLine Citation:
PMID:  23343949     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To assess corneal thickness (CT) and correlation with graft outcome after penetrating keratoplasty in the Cornea Donor Study.
METHODS: A total of 887 subjects with a corneal transplant for a moderate-risk condition (principally Fuchs dystrophy or pseudophakic corneal edema) had postoperative CT measurements throughout a 5-year follow-up time. Relationships between baseline (recipient, donor, and operative) factors and CT were explored. Proportional hazards models were used to assess the association between CT and graft failure. Relationship between CT and cell density was assessed with a longitudinal repeated measures model and Spearman correlation estimates.
RESULTS: Higher longitudinal CT measurements were associated with the following: diagnosis of pseudophakic or aphakic corneal edema (P < 0.001), intraocular pressure >25 mm Hg during the first postoperative month (P = 0.003), white (non-Hispanic) donor race (P = 0.002), and respiratory causes of donor death (P < 0.001). Among those without graft failure within the first postoperative year, the 5-year cumulative incidence (± 95% confidence interval) of graft failure was 5% ± 5% in those with a 1-year CT ≤ 500 μm, 5% ± 3% for CT 501 to 550 μm, 7% ± 4% for CT 551 to 600 μm, and 20% ± 11% for CT >600 μm. In a multivariate analysis, both 1-year CT and cell density were associated with subsequent graft failure (P = 0.002 and 0.009). CT increase was modestly associated with endothelial cell loss during follow-up (r = -0.29).
CONCLUSIONS: During the first 5 years after penetrating keratoplasty, CT can serve as a predictor of graft survival. However, CT is not a substitute for cell density measurement because both measures were independently predictive of graft failure.
David D Verdier; Alan Sugar; Keith Baratz; Roy Beck; Mariya Dontchev; Steven Dunn; Robin L Gal; Edward J Holland; Craig Kollman; Jonathan H Lass; Mark J Mannis; Jeffrey Penta;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cornea     Volume:  32     ISSN:  1536-4798     ISO Abbreviation:  Cornea     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-10     Completed Date:  2013-09-19     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  729-36     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Cell Count
Cornea / pathology*
Corneal Diseases / surgery
Corneal Endothelial Cell Loss / diagnosis*
Corneal Pachymetry
Graft Rejection / diagnosis*
Graft Survival / physiology
Keratoplasty, Penetrating*
Middle Aged
Postoperative Period
Treatment Outcome
Young Adult
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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