Abstract

P 017

Improved corneal graft survival following eyelid repair

Katharina Hauer, Daniel Böhringer, Philipp Eberwein, Hans Mittelviefhaus, Thomas Reinhard

Universitäts-Augenklinik Freiburg

Objective
We hypothesize on the basis of various of case reports, that graft survival following penetrating keratoplasty in eyes with insufficient eyelid closure may be substantially reduced. Deductively we hypothesize, that graft survival may be substantially improved by means of adequate eyelid surgery prior to penetrating keratoplasty.
Methods
We reviewed the records of all 12 patients who underwent penetrating keratoplasty in eyes with insufficient eyelid closure. Only the first keratoplasty of each patient was included. Underlying diseases for insufficient eyelid closure were facial palsy and eyelid defects, evenly distributed between both groups. Lid closure had been sufficiently corrected in five patients at time of keratoplasty (group A), whereas additional eyelid surgery was deemed necessary thereafter in the remaining seven patients (group B). Age at time of penetrating keratoplasty averaged 61 and 64 years in groups A and B, respectively. Follow-up averaged 3 years. We compared clear graft survival between group A and group B by means of Kaplan-Meier estimation and log-rank test.
Results
During follow-up all grafts failed in group B whereas all grafts remained clear in group A. Kaplan Meier estimation of clear graft survival three years postoperatively was 100% in group A and only 50% in group B (p=0.09).
Conclusions
Our retrospective analysis revealed a tendency towards improved graft survival upon eyelid repair prior to penetrating keratoplasty. Other prognostic parameters such as age at time of penetrating keratoplasty and cause of eyelid defect were evenly distributed between the two study groups. We thus suggest that adequate eyelid surgery must be considered a prerequisite for penetrating keratoplasty.

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