Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.ophtha.2012.01.021
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dc.titleIndications, outcomes, and risk factors for failure in tectonic keratoplasty
dc.contributor.authorAng, M.
dc.contributor.authorMehta, J.S.
dc.contributor.authorSng, C.C.A.
dc.contributor.authorHtoon, H.M.
dc.contributor.authorTan, D.T.H.
dc.date.accessioned2014-11-26T08:28:55Z
dc.date.available2014-11-26T08:28:55Z
dc.date.issued2012-07
dc.identifier.citationAng, M., Mehta, J.S., Sng, C.C.A., Htoon, H.M., Tan, D.T.H. (2012-07). Indications, outcomes, and risk factors for failure in tectonic keratoplasty. Ophthalmology 119 (7) : 1311-1319. ScholarBank@NUS Repository. https://doi.org/10.1016/j.ophtha.2012.01.021
dc.identifier.issn01616420
dc.identifier.urihttp://scholarbank.nus.edu.sg/handle/10635/110133
dc.description.abstractPurpose: Outcomes of corneal transplantation for tectonic indications and risk factors for (tectonic and physiologic) graft failure. Design: Retrospective cohort study. Participants: Consecutive patients who underwent keratoplasty for tectonic indications at the Singapore National Eye Centre (SNEC) between January 1, 1991, and December 1, 2009. Methods: Clinical data and donor and recipient characteristics were recorded and analyzed from subjects in the prospective Singapore Corneal Transplant Study. Main Outcome Measures: (1) Tectonic (anatomic) failure defined as recurrence of corneal melt threatening tectonic integrity and requiring additional corneal grafting within 3 months of the primary procedure. (2) Physiologic failure defined as irreversible change in graft clarity preventing recovery in useful vision in grafts initially clear 2 weeks postoperatively. Results: The mean age of the study cohort (n = 362, 193 male and 169 female subjects) was 51.5±20.2 years, with a mean follow-up of 25.8±18.7 months. Patients underwent penetrating keratoplasty (PK) (n = 142, 39.2%), anterior lamellar keratoplasty (ALK) (n = 127, 35.1%), or a peripheral corneoscleral patch graft (n = 93, 25.7%) most commonly for inflammation (n = 68, 18.8%), trauma (n = 66, 18.2%), or infection (n = 66, 18.2%). Risk factors for tectonic failure (18/362 eyes, 5.0%) were severe lid disease (odds ratio [OR], 6.1; 95% confidence interval [CI], 1.7-22.1; P = 0.006), central ALK (OR, 7.5; 95% CI, 1.8-32.4; P = 0.007), and peripheral grafts (OR, 5.7; 95% CI, 1.1-28.3; P = 0.035). Among anatomically successful central grafts (n = 223), the mean physiological graft survival was 96 months (95% CI, 83-110); Kaplan-Meier probabilities for survival at 10 years were 66.8% for ALK and 44.2% for PK. Active corneal inflammation (hazard ratio [HR], 2.5; 95% CI, 1.4-4.4; P = 0.003) and larger donor and recipient graft sizes of
dc.description.urihttp://libproxy1.nus.edu.sg/login?url=http://dx.doi.org/10.1016/j.ophtha.2012.01.021
dc.sourceScopus
dc.typeArticle
dc.contributor.departmentDUKE-NUS GRADUATE MEDICAL SCHOOL S'PORE
dc.description.doi10.1016/j.ophtha.2012.01.021
dc.description.sourcetitleOphthalmology
dc.description.volume119
dc.description.issue7
dc.description.page1311-1319
dc.description.codenOPHTD
dc.identifier.isiut000306011000011
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