Evaluation of triggers for corneal graft rejection

BACKGROUND AND OBJECTIVE: To evaluate potential triggering factors contribu ting to corneal graft rejection. PATIENTS AND METHODS: A prospective, case control study was conducted over a five month period. All patients presenting with new onset corneal graft r ejection were enrolled into the study group. Two patients with clear grafts who presented shortly after each enrolled study group patient served as co ntrols. Groups were matched for age, preoperative diagnosis, and number of previous keratoplasties. Participating patients and examining ophthalmologi sts filled out questionnaires regarding infectious, environmental and immun ologic exposures. RESULTS: 66 patients were enrolled into the study, of which 22 had new reje ction episodes. The most prevalent diagnoses were keratoconus (36.6%) and h erpes simplex keratitis (22.7%). Anterior chamber reaction (77.3%) and kera tic precipitates (68.2%) were the most common signs of graft rejection. A h istory Of prior rejection episodes was significantly more frequent in the s tudy group population (p < 0.001). Factors such as sun exposure, stress, sm oking and travel were more prevalent in the rejection group but not statist ically significant. The history of recent vaccinations and allergic reactio ns were equally prevalent in both groups. CONCLUSIONS: The new onset of corneal graft rejection was highly associated with a prior history of graft rejection episodes (p < 0.001). Other analyz ed factors were not significant triggering factors for rejection in this sm all series.