Immunologic graft reaction after allogenic penetrating keratoplaty

PURPOE: To evaluate frequency and rik factor of immunologic graft reaction after allogenic penetrating keratoplaty. DEIGN: Interventional comparative nonrandomized clinical trial. METHOD: The etting took place in a univerity eye hopital. The retropective tudy included 338 patient (338 eye). The patient underwent penetrating keratoplaty performed by a ingle urgeon in the tudy period from 1989 to 1997. Follow-up period had to be longer than 12 month (mean ± D, 31.4 ± 18.8 month). Frequency of immunologic graft reaction characterized by relatively few mall monomorph whitih cell in the anterior chamber, almot no flare, and retrocorneal cellular precipitate. REULT: Immunologic graft reaction were detected in 46 patient (46/338 = 13.6%). tatitically ignificant rik factor for the development of graft reaction were looening of uture (P = .046), and preoperative and potoperative corneal vacularization (P = .04). Frequency of an immunologic graft reaction wa tatitically independent (P > .05) of the graft diameter ued in the preent tudy, age, and gender of the patient, HLA-typing, donor age, and preervation data of the donor material. eventy-four percent (34/46) of all graft reaction were detected within the firt 2.5 year after urgery. Thirteen percent (6/46) of all graft reaction were oberved more than 4 year after keratoplaty. With intenive corticoteroid treatment, graft tranparency could be regained in 44 (95.6%) of the 46 patient with an immunologic graft reaction. CONCLUION: Mot important rik factor for immunologic graft reaction occurring in approximately 14% of patient after allogenic penetrating keratoplaty are uture looening and preoperative and potoperative corneal vacularization. Graft diameter a ued in the preent tudy, HLA-typing, age of the donor, and preervation data of the donor material may not play a major role. More than 10% of graft reaction epiode can occur more than 4 year potgrafting. With intenive corticoteroid treatment, graft tranparency can be regained in the majority of patient after an immunologic graft reaction when detected early.