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Emergency corneal grafting in the UK: a 6-year analysis of the UK Transplant Registry

Emergency corneal grafting in the UK: a 6-year analysis of the UK Transplant Registry
Emergency corneal grafting in the UK: a 6-year analysis of the UK Transplant Registry
Background: corneal graft (CG) surgery is the most common and successful tissue transplant worldwide. A small and important group of patients are operated in emergency situations, typically to save a perforated eye. Our knowledge of the indications and outcomes of emergencycorneal graft (eCG) is limited.

Methods: retrospective, multifactorial analysis of all CGs registered by the UK Transplant Service from April 1999 to March 2005.

Results: a total of 12 976 CGs were performed. 1330 (11.4%) were eCGs including 433 regrafts. Actual perforation occurred in 876 (65.9%) patients. 420 (31.5%) grafts were for tectonic purposes alone and 217 (16.3%) were also grafted for visual rehabilitation. The main diagnostic categories were infection (39.4%), non- infectious ulcerative keratitis (32.2%) and other causes (ectasias, previous ocular surgery, injury, dystrophies and opacification). Graft survival of first eCG at 1, 2 and 5 years was 78%, 66% and 47%, respectively. Best-corrected visual acuity of surviving grafts at 1 year was: 6/12 or better in 29.9%, 6/18 to 6/60 in 38.4%, counting finger to LP in 30.6% and NPL in 1%, with worsening of vision in only 8.7% of the patients.

Conclusion: this study which is the largest of its kind shows that despite the seriousness of the critical corneal pathology and the surgical challenges that it poses, the outcomes of eCG are favourable with most patients keeping their eyesight and avoiding immediate rejection. These clinical outcomes show the value of eye banking facilities that are developed to support corneal tissue supply for eCG.
0007-1161
1-6
Hossain, Parwez
563de5fc-84ad-4539-9228-bde0237eaf51
Tourkmani, Abdo Karim
940ed093-4e2b-4687-b7fb-b12902dd3bd2
Kazakos, Dimitri
100b19ea-bdfb-4add-9e1c-d1b17caa8549
Jones, Mark
47129f15-3f9e-44ac-add6-b98c4675ba10
Anderson, David
ace373df-c58c-4cd4-941f-1a596a62b5a8
Hossain, Parwez
563de5fc-84ad-4539-9228-bde0237eaf51
Tourkmani, Abdo Karim
940ed093-4e2b-4687-b7fb-b12902dd3bd2
Kazakos, Dimitri
100b19ea-bdfb-4add-9e1c-d1b17caa8549
Jones, Mark
47129f15-3f9e-44ac-add6-b98c4675ba10
Anderson, David
ace373df-c58c-4cd4-941f-1a596a62b5a8

Hossain, Parwez, Tourkmani, Abdo Karim, Kazakos, Dimitri, Jones, Mark and Anderson, David (2017) Emergency corneal grafting in the UK: a 6-year analysis of the UK Transplant Registry. British Journal of Ophthalmology, 1-6. (doi:10.1136/bjophthalmol-2016-309870).

Record type: Article

Abstract

Background: corneal graft (CG) surgery is the most common and successful tissue transplant worldwide. A small and important group of patients are operated in emergency situations, typically to save a perforated eye. Our knowledge of the indications and outcomes of emergencycorneal graft (eCG) is limited.

Methods: retrospective, multifactorial analysis of all CGs registered by the UK Transplant Service from April 1999 to March 2005.

Results: a total of 12 976 CGs were performed. 1330 (11.4%) were eCGs including 433 regrafts. Actual perforation occurred in 876 (65.9%) patients. 420 (31.5%) grafts were for tectonic purposes alone and 217 (16.3%) were also grafted for visual rehabilitation. The main diagnostic categories were infection (39.4%), non- infectious ulcerative keratitis (32.2%) and other causes (ectasias, previous ocular surgery, injury, dystrophies and opacification). Graft survival of first eCG at 1, 2 and 5 years was 78%, 66% and 47%, respectively. Best-corrected visual acuity of surviving grafts at 1 year was: 6/12 or better in 29.9%, 6/18 to 6/60 in 38.4%, counting finger to LP in 30.6% and NPL in 1%, with worsening of vision in only 8.7% of the patients.

Conclusion: this study which is the largest of its kind shows that despite the seriousness of the critical corneal pathology and the surgical challenges that it poses, the outcomes of eCG are favourable with most patients keeping their eyesight and avoiding immediate rejection. These clinical outcomes show the value of eye banking facilities that are developed to support corneal tissue supply for eCG.

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Accepted/In Press date: 23 April 2017
e-pub ahead of print date: 11 May 2017
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 410634
URI: https://eprints.soton.ac.uk/id/eprint/410634
ISSN: 0007-1161
PURE UUID: 400ec779-0a78-41c9-b2a4-597738042e74
ORCID for Parwez Hossain: ORCID iD orcid.org/0000-0002-3131-2395

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Date deposited: 09 Jun 2017 09:16
Last modified: 10 Dec 2019 06:02

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Contributors

Author: Parwez Hossain ORCID iD
Author: Abdo Karim Tourkmani
Author: Dimitri Kazakos
Author: Mark Jones
Author: David Anderson

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