Graft Reepithelialization after Penetrating Keratoplasty Using Organ-Cultured Donor Tissue
Received 27 October 2005; accepted 12 June 2006. published online 21 September 2006.
Objective
To analyze graft reepithelialization after penetrating keratoplasty using organ-cultured donor tissue.
Design
Retrospective observational cohort study.
Participants
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).
Methods
Slit-lamp examination after fluorescein staining.
Main Outcome Measure
Graft reepithelialization time was recorded.
Results
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 (β = 0.07; P = 0.045), use of sodium hyaluronate at the end of surgery (β = −0.17; P = 0.001), and steroid regimen (β = 0.09; P = 0.022) significantly influenced the graft reepithelialization time.
Conclusions
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.
Department of Ophthalmology, Centre Hospitalier National d’Ophtalmologie des XV–XX, Paris VI University, Paris, France.
Correspondence and reprint requests to Vincent M. Borderie, MD, PhD, Service V, Centre Hospitalier National d’Ophtalmologie des XV–XX, 28 rue de Charenton, 75012 Paris, France.
Manuscript no. 2005-1026.
The authors have no proprietary, commercial, or financial interests in any of the products described in the article.
Supported by the Paris VI University (Université Pierre et Marie Curie).
ABSTRACT