Preexisting and XXXX in repeated corneal transplantation.

@entity1 @entity227 @entity228 @entity726 @entity86 @entity288
PURPOSE: To evaluate the incidence, risk factors, management, and visual outcome of @entity86 in comparison with preexisting @entity726 in repeated corneal transplantation. METHODS: The charts of all the @entity1 who underwent repeated corneal transplantation between 1985 and 1998 were reviewed for the occurrence of preexisting and @entity86 . Eighty @entity1 underwent 122 repeated corneal transplantations, of which six underwent surgery in both eyes. The mean follow-up period from the primary keratoplasty was 89.5 months and the minimal follow-up period was at least 6 months after the last transplantation. RESULTS: @entity86 affected 29 eyes (34%) in 28 @entity1 (35%) with repeated corneal transplantation. Herpetic scar as an indication for transplantation and a history of previous immune graft rejection were more common in @entity1 who developed @entity86 compared with the entire regrafted group ( p= 0.016 and p< 0.001, respectively). The incidence of @entity726 usually increased with the increased number of keratoplasties. The following types of @entity726 were disclosed: closed angle (59%), @entity228 induced (21%), open angle (11%), angle recession (3%), aqueous misdirection (3%), and unknown cause (3%). Surgical intervention was required in 62%. @entity726 was controlled in nine eyes (31%) and resolved following regrafting or discontinuation of @entity288 in four eyes (14%), of which five (17%) had clear regrafts. Better intraocular pressure control was achieved in those cases that did not require surgical intervention ( p= 0.019). In 15 eyes (52%), regrafts failed due to uncontrolled @entity726 and/or other causes. At the end of the follow-up period, visual acuity was 20/30 to 20/200 in 17%, counting fingers from less than 20 ft in 31%, hand movement/light perception in 35%, and no light perception in 17%. Six of the 86 eyes (7%) in six @entity1 (7.5%) had preexisting @entity726 . Graft clarity and @entity726 control in @entity1 with preexisting @entity726 were similar to those of @entity726 (50% had controlled @entity726 and 33% had clear regraft). CONCLUSIONS: @entity726 , either preexisting or postoperative, is one of the most devastating complications of repeated corneal transplantation and the cause for regraft failure and @entity227 even when intensively treated. Close monitoring and early targeted therapy are warranted to increase the survival of repeated corneal transplants in eyes affected by @entity726 .
