Study finds new key to corneal transplant success

Jul 01, 2010

Although it is already one of medicine's most successful transplant procedures, doctors continue to seek ways to improve corneal transplants. Now, for the first time, a team of German and British researchers have confirmed that failure and rejection of transplanted corneas are more likely in patients whose eyes exhibit abnormal vessel growth, called corneal neovascularization, prior to surgery. The meta-analysis report appears in July Ophthalmology, the journal of the American Academy of Ophthalmology. The findings also suggest a new treatment approach that could improve transplant success rates.

Claus Cursiefen, MD, and colleagues reviewed 19 studies involving nearly 24,500 corneal transplants (called "grafts"). The cornea is the eye's clear outer surface that provides much of the visual power.

"The presence of corneal neovascularization before surgery makes it about 30 percent more likely that the transplant will fail, and more than doubles the risk of graft rejection," said Dr. Cursiefen. "We also found that the risks of failure and rejection rise with the extent of vascularization-the more extensive the corneal neovascularization, the higher the risks."

These findings suggest that patients who have corneal neovascularization might benefit from treatment before with growth-inhibiting drugs (antiangiogenics) such as or ranibizumab, or with another type of drug that works at the level of to discourage ; one such drug, GS101, is now in clinical trials. This "preconditioning" approach is worthy of thorough testing and assessment, the researchers say.

"In the future, preconditioning a vascularized cornea before transplantation may be a useful strategy to promote survival of the graft," Dr. Cursiefen said.

More than 40,000 transplant surgeries are performed annually in the United States to restore vision in people whose have been damaged by injury or illness. It is, in fact, the most common form of tissue transplant. In patients whose corneas are nonvascular at the time of surgery, the chance of success is high: up to 81 percent of transplants remain healthy at five-year follow up.

Ophthalmologists (Eye M.D.s) already use a number of pre-surgery measures to encourage corneal transplant success, such as matching donor and recipient tissues as closely as possible and suppressing the immune response in the person receiving the graft. After transplant the doctor monitors the patient closely for signs of failure and treats early and aggressively if warning signs appear.

Dr. Cursiefen's review found that increasing age and male gender appear to be additional, independent risk factors for graft failure, but not for graft rejection; he says further study is needed to confirm these findings. In June 2009 (Ophthalmology) the Cornea Donor Study reported lower rates of success in patients who had corneal edema (swelling) after surgery for cataract removal and intraocular lens implantation, and in glaucoma patients.

Explore further: Non-stop PET/CT scan provides accurate images

Provided by American Academy of Ophthalmology

5 /5 (1 vote)
add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Non-stop PET/CT scan provides accurate images

26 minutes ago

Siemens is improving PET/CT imaging and data quality while reducing radiation exposure. The Biograph mCT Flow PET/CT scanner is a new positron emission tomography/computed tomography (PET/CT) system that, ...

Experts: Chopin's heart shows signs of TB

21 hours ago

The preserved heart of composer Frederic Chopin contains signs of tuberculosis and possibly some other lung disease, medical experts said Wednesday.

The argument in favor of doping

Sep 17, 2014

Ahead of Friday's court ruling on whether ASADA's investigation into the Essendon Football Club was lawful, world leader in practical and medical ethics Professor Julian Savulescu, looks at whether there is a role for performance-enhancing ...

Errata frequently seen in medical literature

Sep 16, 2014

(HealthDay)—Errata, including those that may materially change the interpretation of data, are frequent in medical publications, according to a study published in the August issue of The American Journal of ...

User comments : 0