To investigate the incidence of adverse reactions after corneal transplantation, reported to the Eye Bank Association of America.
Incidence of adverse reactions from January 1, 2007, to December 31, 2014, was analyzed.
Of the 354,930 transplants performed in the United States, adverse reactions were reported in 494 cases (0.139%). Primary graft failure (PGF) predominated (n = 319; 0.09%) followed by endophthalmitis (n = 99; 0.028%) and keratitis (n = 66; 0.019%). The procedure type predominantly associated with PGF was endothelial keratoplasty (EK) in 56% (n = 180; 11 per 10,000 grafts), followed by penetrating keratoplasty (PK) in 42% (n = 135; 6.9 per 10,000 grafts). The procedure type predominantly associated with endophthalmitis and keratitis was EK in 63% (n = 104; 6.3 per 10,000 grafts) followed by PK in 34% (n = 56; 2.8 per 10,000 grafts), anterior lamellar keratoplasty in 1% (n = 2; 2.7 per 10,000 grafts), and keratoprosthesis in 1% (n = 2; 12.4 per 10,000 grafts). Although the incidence of PGF and endophthalmitis between PK and EK was noteworthy, the difference was not statistically significant (P = 0.098). Endophthalmitis-associated pathogens were isolated in 78% of cases: predominantly Candida species (65%), gram-positive organisms (33%), and gram-negative rods (2%). Keratitis-associated pathogens were isolated in 64% of cases: predominantly Candida species (81%), Herpes simplex virus (7%), gram-negative organisms (7%), and gram-positive organisms (5%).
PGF was the most commonly reported adverse reaction, disproportionately associated with EK. An increasingtrend in the rate of endophthalmitis and keratitis was observed, disproportionately associated with EK and Candida species.
*Department of Ophthalmology, Saint Louis University School of Medicine, Saint Louis, MO;
†Eye Bank Association of America, Washington, DC;
‡Lions VisionGift, Portland, OR;
§Division of Ophthalmologyl; and
¶Center for Biomedical Research Informatics, NorthShore University HealthSystem, Division of Ophthalmology, Evanston, IL.
Reprints: Sean L. Edelstein, MD, 1755 S. Grand Boulevard, St. Louis, MO 63104 (e-mail: firstname.lastname@example.org).
The authors have no funding or conflicts of interest to disclose.
Received January 03, 2016
Received in revised form March 13, 2016
Accepted March 14, 2016