| 1. |
- Dunker, Suryan L., et al.
(författare)
-
Outcomes of corneal transplantation in Europe : report by the European Cornea and Cell Transplantation Registry
- 2021
-
Ingår i: Journal of Cataract and Refractive Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 1873-4502 .- 0886-3350. ; 47:6, s. 780-785
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To analyze real-world graft survival and visual acuity outcomes of corneal transplantation in Europe. SETTING: Corneal clinics in 10 European Union member states, the United Kingdom, and Switzerland. DESIGN: Multinational registry study. METHODS: All corneal transplant procedures registered in the European Cornea and Cell Transplantation Registry (ECCTR) were identified. Graft survival of primary corneal transplants were analyzed using Kaplan-Meier survival curves with log-rank test and Cox regression. Corrected distance visual acuities (CDVAs) are reported at baseline and 2 years postoperatively using the Lundström distribution matrix. RESULTS: A total of 12 913 corneal transplants were identified. Overall, 32-year graft survival of corneal transplants was high (89%) but differed between indications, ranging from 98% in keratoconus and 80% for trauma. Overall, CDVA improved postoperatively, but the risk for losing vision ranged from 7% (baseline vision ≤0.1 Snellen) to 58% (baseline vision ≥1.0 Snellen). CONCLUSIONS: This report provides a comprehensive overview of graft survival and visual outcomes of corneal transplantation in Europe. In addition, it provides real-world estimates of outcomes for a variety of indications and surgical techniques to support benchmarking and demonstrates the relationship between baseline and postoperative vision.
|
|
| 2. |
- Dunker, Suryan L., et al.
(författare)
-
Practice patterns of corneal transplantation in Europe : first report by the European Cornea and Cell Transplantation Registry
- 2021
-
Ingår i: Journal of Cataract and Refractive Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 1873-4502 .- 0886-3350. ; 47:7, s. 865-869
-
Forskningsöversikt (refereegranskat)abstract
- PURPOSE: To report practice patterns of corneal transplantation in Europe. SETTING: Corneal clinics in 10 European member states (MS), the United Kingdom, and Switzerland. DESIGN: Multinational registry study. METHODS: Corneal transplant procedures registered in the European Cornea and Cell Transplantation Registry were identified. Preoperative donor and recipient characteristics, indication and reason for transplantation, and surgical techniques were analyzed. RESULTS: A total of 12 913 corneal transplants were identified from 10 European Union MS, the United Kingdom, and Switzerland. Most countries were self-sufficient with regard to donor tissue. Fuchs endothelial corneal dystrophy was the most common indication (41%, n = 5325), followed by regraft (16%, n = 2108), pseudophakic bullous keratopathy (12%, n = 1594), and keratoconus (12%, n = 1506). Descemet stripping automated endothelial keratoplasty (DSAEK, 46%, n = 5918) was the most commonly performed technique, followed by penetrating keratoplasty (30%, n = 3886) and Descemet membrane endothelial keratoplasty (9%, n = 1838). Vision improvement was the main reason for corneal transplantation (90%, n = 11 591). Surgical technique and reason for transplantation differed between indications. CONCLUSIONS: This report provides the most comprehensive overview of corneal transplantation practice patterns in Europe to date. Fuchs endothelial dystrophy is the most common indication, vision improvement the leading reason, and DSAEK the predominant technique for corneal transplantation.
|
|
| 3. |
- Claesson, Margareta, 1951, et al.
(författare)
-
Astigmatism and the Impact of Relaxing Incisions After Penetrating Keratoplasty
- 2006
-
Ingår i: Journal of Refractive Surgery. - 1081-597X. ; 23:3, s. 284-9
-
Tidskriftsartikel (refereegranskat)abstract
- Astigmatism and the impact of relaxing incisions after penetrating keratoplasty.Claesson M, Armitage WJ. Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden. margareta.l.claesson@vgregion.se PURPOSE: To determine the impact of relaxing incisions for correcting postoperative astigmatism following penetrating keratoplasty. METHODS: Data were collected through the Swedish Corneal Transplant Register. Of the 1161 grafts with complete 2-year follow-up, 131 underwent relaxing incisions. Stepwise multiple regression was used to determine the factors that influenced the extent of astigmatism in diopters (D) (square root transformed). The change in astigmatism brought about by relaxing incisions was evaluated both by subtraction (ie, ignoring angle) and vector analysis. RESULTS: The overall mean astigmatism was 4.56 D (95% confidence interval [CI]: 4.40-4.73, n = 1161). The final regression model explained only a small proportion of the overall variability of the data (< 5%). There was a slight increase in postoperative astigmatism with recipient age (P = .025), and two of the seven participating clinics achieved lower levels of astigmatism (P = .001 and P = .036, respectively). In patients who underwent relaxing incisions, astigmatism was reduced from 8.40 D (95% CI: 8.0-9.0, n = 131) to 3.80 D (95% CI: 3.5-4.3). The mean difference by subtraction was 4.50 D (95% CI: 4.0-5.0, P < .001, paired t test). Vector analysis showed the overall reduction of astigmatism due to surgery to be 7.90 D (95% CI: 7.2-8.7). Compared with grafts with no refractive surgery, a trend was noted that suggested corrected visual acuity was improved following relaxing incisions. CONCLUSIONS: Relaxing incisions were found to be a safe and effective method for reducing postoperative astigmatism and may improve visual acuity. PMID: 17385295 [PubMed - indexed for MEDLINE]
|
|
| 4. |
- Claesson, Margareta, 1951, et al.
(författare)
-
Corneal oedema after cataract surgery: predisposing factors and corneal graft outcome.
- 2009
-
Ingår i: Acta ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 87:2, s. 154-9
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Pseudophakic bullous keratopathy (PBK) is one of the main indications for corneal transplantation. Graft survival and visual outcome in this group are often poorer than for other indications. The aim of this study was to find risk factors for developing corneal oedema after cataract surgery and factors that influence the subsequent survival of the graft and the visual outcome. METHODS: We carried out an observational, retrospective cohort study using data from the Swedish Cornea Transplant Register and patient medical records. A total of 273 patients whose indication for corneal transplantation was corneal oedema after cataract surgery were included in the study. Multiple logistic regression analysis and, where appropriate, univariate analyses were applied. RESULTS: A total of 43% of the patients developed persistent corneal oedema immediately after cataract surgery, the main risk factors for which were phacoemulsification and pre-existing endothelial disease. Almost a third (32%) of the transplants for PBK failed within 2 years, for which rejection and other postoperative complications increased the risk. Half (50%) the patients had visual acuity < or = 0.1 at 2 years after keratoplasty. Comorbidity, increasing duration of the bullous keratopathy and increasing age affected the visual outcome negatively. CONCLUSIONS: Phacoemulsification was a risk factor for immediate persistent corneal oedema after cataract surgery, although it did not increase the overall risk of developing PBK. However, transplants for immediate PBK had a better survival rate than those for later onset PBK. Shorter duration of PBK and intraocular lens exchange at the time of penetrating keratoplasty increased the likelihood of good visual acuity.
|
|
| 5. |
- Claesson, Margareta, et al.
(författare)
-
Validation of Catquest-9SF-A Visual Disability Instrument to Evaluate Patient Function after Corneal Transplantation
- 2017
-
Ingår i: Cornea. - 0277-3740 .- 1536-4798. ; 36:9, s. 1083-1088
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Catquest-9SF is a 9-item visual disability questionnaire developed for evaluating patient-reported outcome measures after cataract surgery. The aim of this study was to use Rasch analysis to determine the responsiveness of Catquest-9SF for corneal transplant patients. Methods: Patients who underwent corneal transplantation primarily to improve vision were included. One group (n = 199) completed the Catquest-9SF questionnaire before corneal transplantation and a second independent group (n = 199) completed the questionnaire 2 years after surgery. All patients were recorded in the Swedish Cornea Registry, which provided clinical and demographic data for the study. Winsteps software v.3.91.0 (Winsteps.com, Beaverton, OR) was used to assess the fit of the Catquest-9SF data to the Rasch model. Results: Rasch analysis showed that Catquest-9SF applied to corneal transplant patients was unidimensional (infit range, 0.73-1.32; outfit range, 0.81-1.35), and therefore, measured a single underlying construct (visual disability). The Rasch model explained 68.5% of raw variance. The response categories of the 9-item questionnaire were ordered, and the category thresholds were well defined. Item difficulty matched the level of patients' ability (0.36 logit difference between the means). Precision in terms of person separation (3.09) and person reliability (0.91) was good. Differential item functioning was notable for only 1 item (satisfaction with vision), which had a differential item functioning contrast of 1.08 logit. Conclusions: Rasch analysis showed that Catquest-9SF is a valid instrument for measuring visual disability in patients who have undergone corneal transplantation primarily to improve vision.
|
|
| 6. |
|
|
| 7. |
- Potapenko, Ivan O., et al.
(författare)
-
Donor Endothelial Cell Count Does Not Correlate With Descemet Stripping Automated Endothelial Keratoplasty Transplant Survival After 2 Years of Follow-up
- 2017
-
Ingår i: Cornea. - : Lippincott Williams & Wilkins. - 0277-3740 .- 1536-4798. ; 36:6, s. 649-654
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To analyze the influence of low endothelial cell density (ECD) of donor cornea tissue, donor age, and sex on the transplant survival rate after Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: Graft ECD, age, and sex of donors used for DSAEK (n = 1789) during 7 years (2007-2014) in 4 Scandinavian hospitals were assessed for potential association with transplant survival at 2 years of follow-up using a Cox regression model correcting for confounding factors. The data were obtained from The Swedish Cornea Transplant Registry. Results: Transplant failure occurred in 196 patients, with 69 early failures during the first 3 postoperative months, and 127 late secondary failures. Twenty-five of the late secondary failures were due to rejection. Reversible rejections occurred in 67 patients. There was no significant impact of donor age [hazard ratio (HR) 1.0, 95% confidence interval (CI), 0.99-1.02, P = 0.32] or endothelial cell count (HR 1.00, 95% CI, 0.99-1.01, P = 0.3) on the survival rate of DSAEK transplants at 2 years of follow-up. The use of donor grafts with low ECD (, 2300 cells/mm(2)) did not influence the survival rate (HR 1.3, 95% CI, 0.76-2.35, P = 0.31). Male donor sex was associated with lower 2-year graft survival (HR 1.5, 95% CI, 1.042.28, P = 0.03), but not with rejection events (P = 0.26). Conclusions: Based on data from The Swedish Cornea Transplant Registry, low donor ECD was not detrimental to graft survival, whereas donor sex seemed to influence the outcome at the end of the 2-year follow-up.
|
|
| 8. |
- Viberg, Andreas, et al.
(författare)
-
Incidence of corneal transplantation after phacoemulsification in patients with corneal guttata : a registry-based cohort study
- 2020
-
Ingår i: Journal of cataract and refractive surgery. - : Lippincott Williams & Wilkins. - 0886-3350 .- 1873-4502. ; 46:7, s. 961-966
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the risk for corneal transplantation after phacoemulsification related to corneal guttata.Setting: Forty-nine Swedish cataract surgical units and 7 Swedish cornea transplantation units.Design: Registry-based cohort study.Methods: Patient data from the Swedish National Cataract Registry between 2010 and 2012 were linked with data from the Swedish Cornea Transplant Registry between 2010 and September 2017. Data from cataract patients were linked with data from patients who underwent corneal transplantation because of endothelial failure. Triple procedures and other surgical methods for cataract extraction other than phacoemulsification were excluded. If both eyes had surgery, 1 eye was randomly selected from the registry to obtain unrelated samples. The incidence was calculated per 10 000 person years, and Poisson regression analysis was used to investigate the risk for corneal transplantation because of endothelial failure after phacoemulsification.Results: Altogether, data from 276 362 cataract patients were linked with data from 2091 patients who underwent corneal transplantation. The incidence rate of corneal transplantation after phacoemulsification among patients with corneal guttata was 88 per 10 000 person years (95% CI, 74.5-103.1). The annual incidence rate was highest within the first year and diminished thereafter. The incidence rate of corneal transplantation among patients without corneal guttata was 1.4 per 10 000 person years (95% CI, 1.2-1.6). Phacoemulsification in patients with corneal guttata was associated with corneal transplantation with an adjusted relative risk of 68.2 (95% CI, 54.0-86.2).Conclusions: The relative risk for corneal transplantation after phacoemulsification was 68.2 times higher for patients with corneal guttata than that for those without. Still, most of the patients with corneal guttata did not undergo corneal transplantation during the study period.
|
|
| 9. |
- Viberg, Andreas, et al.
(författare)
-
Risk of corneal transplantation after phacoemulsification in patients with cornea guttata
- 2019
-
Ingår i: Acta Ophthalmologica. - : John Wiley & Sons. - 1755-375X .- 1755-3768. ; 97:S263
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: To investigate the risk of corneal transplantation after phacoemulsification related to cornea guttata.Methods: In this retrospective registry‐based cohort study, patient data from the Swedish National Cataract Register for years 2010‐2012 were linked with data from the Swedish Cornea Transplant Register for years 2010‐2017. Altogether, data from 276,354 cataract patients was linked with data from 2,091 patients with primary and secondary endothelial failure as indication for corneal transplantation. Other surgical methods for cataract extraction than phacoemulsification were excluded. If both eyes had surgery, one eye was randomly selected to obtain unrelated samples. A Kaplan‐Meier curve and Cox regression analysis were used to investigate the risk for corneal transplantation due to endothelial failure after phacoemulsification.Results: Out of the 3,346 phacoemulsification patients with cornea guttata, 153 underwent corneal transplantation within 6.2 years in median. The cumulative transplantation rate, 6 years after the phacoemulsification was 4.8% in the group with cornea guttata and 0.08% in the group without. The annual transplantation rate among the cornea guttata patients during the first year was 1.64% and diminished the following 5 years to 0.55% in average. The annual transplantation rate among the patients without cornea guttata was 0.01% in average after phacoemulsification during the same period of time. The transplantation hazard ratio for cornea guttata present at the phacoemulsification was 67.6 (95% CI: 53.6.0‐85.3, p < 0.001), when adjusting for potential confounders.Conclusions: The hazard of corneal transplantation after phacoemulsification was 67.6 times higher with cornea guttata than without. Still, the great majority of the patients with cornea guttata did not undergo corneal transplantation during the study period.
|
|
