Patients with infectious uveitis at greater risk for corneal graft failure
Patients with infectious uveitis are at an increased risk for corneal graft failure compared with patients with noninfectious uveitis, according to a study published in Cornea.
“Patients with uveitis are much more complex candidates for corneal transplantation, and graft survival in this population is diminished,” study co-author Julie M. Schallhorn, MD, MS, told Healio/OSN. “This is especially true for patients with viral causes of uveitis, and special attention needs to be given in this population to the balance between viral suppression and immunosuppression.”
Schallhorn and colleagues conducted a retrospective chart review identifying 70 transplants in 42 patients with uveitis. Patients underwent 40 primary transplants and 30 repeat transplants over a 9-year period.
Researchers included all patients with uveitis who underwent a corneal transplant between June 2010 and May 2018 at two major academic centers. Patients without preoperative or operative data and patients with less than 3 months of follow-up were excluded.
Graft failure occurred in 43 eyes (61%) of 22 patients (52%). The median graft survival time was 24.1 months.
Age, sex and location of uveitis in transplant recipients were not associated with an increased risk for graft failure. Worse preoperative visual acuity scores were associated with graft failure (P < .001), and there was a higher rate of failure in patients with infectious uveitis compared with noninfectious uveitis (P = .031).
Grafts in eyes with infectious uveitis had a median survival time of 11 months compared with 33.4 months for grafts in eyes with noninfectious uveitis, and patients with successful grafts had inflammation controlled for longer before the procedure compared with failed grafts (P = .004), according to the study.
Loss to follow-up and heterogeneity in uveitis location, diagnosis and control methods were identified as weaknesses of the study.