Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery

Figures & data

Table 1 Comparison Of Clinical Characteristics Between Patients With Traumatic And Non-Traumatic Graft Dehiscence

	Traumatic		Non-Traumatic		p-value^a
	(n = 28)		(n = 43)
	n	(%)	n	(%)	p-value
Sex					0.461
Male	19	(68%)	25	(58%)
Female	9	(32%)	18	(42%)
Eye					0.332
Left	11	(39%)	23	(53%)
Right	17	(61%)	20	(47%)
Indication for graft					0.115
Other	1	(4%)	2	(5%)
Keratoconus	17	(61%)	19	(44%)
Pseudophakic bullous keratopathy	3	(11%)	3	(7%)
Microbial keratitis with perforation	0	(0%)	5	(12%)
Herpes simplex	0	(0%)	6	(14%)
Pellucid marginal degeneration	0	(0%)	1	(2%)
Fuchs’ endothelial dystrophy	3	(11%)	1	(2%)
Traumatic corneal scarring	2	(7%)	4	(9%)
Ocular cicatricial pemphigoid	0	(0%)	1	(2%)
Corneal dystrophy	1	(4%)	1	(2%)
Unknown	1	(4%)	0	(0%)
Type of graft					0.508
Penetrating keratoplasty	25	(89%)	35	(81%)
Deep anterior lamellar keratoplasty	3	(11%)	8	(19%)
Suture type^c					0.647
Interrupted	23	(96%)	39	(91%)
Continuous	1	(4%)	4	(9%)
Graft sutures removed prior to dehiscence					0.327
No	10	(36%)	21	(50%)
Yes	18	(64%)	21	(50%)
More than half of the sutures removed if removed					0.464
No	3	(17%)	6	(29%)
Yes	15	(83%)	15	(71%)
IOP >21mmHg in 1st month post-op^c					0.545
No	21	(78%)	36	(84%)
Yes	6	(22%)	7	(16%)
	Median	(IQR)	Median	(IQR)	p-value^b
Age at grafting (years)	34.9	(29.7, 62.8)	58.8	(36.2, 77.1)	0.030
Age of patient at time of dehiscence (years)	48.4	(32.9, 72.2)	62.7	(38.2, 78.6)	0.196
Age of graft at time of dehiscence (years)	2.3	(0.3, 14.8)	0.2	(0.1, 2.0)	0.010
Time to dehiscence repair (days)	0	(0, 0)	0	(0, 2)	0.059
Highest IOP 1^st month post-op (mmHg)^c	17	(11, 22)	15	(10, 19)	0.186
BCVA pre-graft (LogMAR)	1.50	(1.00, 3.00)	2.00	(1.00, 3.00)	0.855
BCVA pre-dehiscence (LogMAR)	0.48	(0.18, 1.50)	1.00	(0.50, 2.00)	0.014
BCVA 1 week post-repair (LogMAR)	2.00	(0.54, 3.00)	1.00	(0.60, 2.00)	0.157
BCVA 3 months post-repair (LogMAR)	0.95	(0.30, 2.50)	1.00	(0.48, 2.00)	0.582
BCVA 6 months post-repair (LogMAR)	1.00	(0.44, 2.00)	0.78	(0.48, 2.00)	0.620

Notes: ^aP-value derived using Fisher’s exact test. ^bP-value derived using Wilcoxon the rank-sum test. ^cMissing value for IOP in first month (n = 1) and suture type (n = 4).

Abbreviations: BCVA, best-corrected visual acuity; IOP, intraocular pressure; IQR, interquartile range.

Table 2 Factors Associated With Visual Acuity Outcomes Derived From Univariable Linear Regression Analysis

	LogMAR Visual Acuity
	1 Week Post-Dehiscence				3 Months Post-Dehiscence				6 Months Post-Dehiscence
	%^a	95% CI		p-value	%^a	95% CI		p-value	%^a	95% CI		p-value
Age at grafting (years)	0.7	0.2	1.2	0.003	0.6	0.1	1.1	0.019	0.5	0.1	1.0	0.031
Age of patient at time of dehiscence (years)	1.0	0.6	1.4	<0.001	0.8	0.4	1.3	0.001	0.7	0.2	1.2	0.004
Age of graft at time of dehiscence (years)	2.2	0.9	3.6	0.001	1.9	0.5	3.3	0.007	1.4	0.0	2.9	0.047
Time to dehiscence repair (days)	−1.5	−3.9	1.0	0.238	−1.9	−4.4	0.7	0.140	−1.1	−3.7	1.5	0.393
Highest IOP 1st month post-op (mmHg)	−0.6	−1.9	0.8	0.388	−0.5	−1.9	0.9	0.456	−0.2	−1.6	1.2	0.757
Log transformed BCVA pre-graft	48.4	9.8	100.5	0.011	34.5	−2.1	84.7	0.067	19.7	−13.3	65.3	0.269
Log transformed BCVA pre-dehiscence	65.1	30.7	108.5	<0.001	69.6	33.5	115.5	<0.001	51.2	17.5	94.5	0.002
Sex
Male	Reference				Reference				Reference
Female	34.2	7.7	67.2	0.010	18.6	−6.2	50.0	0.151	13.1	−10.7	43.3	0.301
Cause
Traumatic	Reference				Reference				Reference
Non-traumatic	−15.9	−32.9	5.4	0.132	2.7	−19.0	30.1	0.826	−5.6	−25.5	19.5	0.628
Keratoconus
No	Reference				Reference				Reference
Yes	−29.8	−43.0	−13.6	0.001	−33.0	−45.7	−17.3	<0.001	−37.3	−48.8	−23.2	<0.001
Graft type
Penetrating keratoplasty	Reference				Reference				Reference
Deep anterior lamellar keratoplasty	−34.9	−51.4	−12.8	0.005	−30.1	−48.6	−4.9	0.023	−28.2	−47.3	−2.1	0.036
Sutures
Interrupted	Reference				Reference				Reference
Continuous	23.2	−19.6	88.7	0.332	39.3	−9.6	114.7	0.130	41.2	−8.3	117.3	0.115
Suture removal
No	Reference				Reference				Reference
Yes	29.9	4.4	61.7	0.020	28.0	1.8	60.8	0.035	14.7	−9.2	44.9	0.245

Notes: ^aValues indicate the percentage difference in logMAR BCVA per unit increase in the predictor. Positive values indicate worse vision.

Abbreviations: BCVA, best-corrected visual acuity; IOP, intraocular pressure.