A 13-year descriptive study of corneal transplants at a tertiary, teaching hospital in northwest Iran

Abstract

Background & Aims: Corneal transplantation is considered the most transplanted solid tissue in humans. The purpose of the present investigation was to recognize the main indications and risk factors for allograft rejection. Materials & Methods: The medical files of all subjects who underwent penetrating keratoplasty at a major referral center in Northwest Iran (Urmia Imam Hospital) were retrospectively reviewed, regardless of the indication for transplantation, over a 13-year period, from 20 March 2002 to 19 March 2015. Results: In total, 327 cases of corneal transplantation were examined (mean age: 53.48 ± 22.44 years). Of these, 170 patients (52%) were male. Out of 327 individuals, 42 cases (12.8%) experienced graft rejection. Nearly three-quarters of rejected transplants (N = 31, 73.8%) occurred in patients ≥ 40 years (p = 0.381). No significant association was detected between graft rejection and gender (p = 0.136). The most frequent indications for corneal transplantation in cases with rejection were leukoma (N = 13, 31.0%), trauma (N = 12, 28.6%), and pseudophakic bullous keratopathy (PBK) (N = 9, 21.4%). The most prevalent causes of graft rejection included delayed follow-up (N = 17, 40.4%), recurrence of corneal dystrophies (N = 9, 21.4%), and graft failure (N = 9, 21.4%). Only 3 out of 17 patients (17.6%) with delayed follow-up achieved graft restoration. Conclusion: This study suggests a link between delayed follow-up and graft rejection. Prompt intervention improves the chances of regaining graft clarity, and patients must be well informed about the importance of follow-up visits.

Keywords

• bullous keratopathy
• corneal transplantation
• graft rejection
• trauma