Outcome of corneal transplantation rejection

Purpose, To identify predictive factors for reversibility of corneal graft rejection. Methods. The study design was a prospective cohort study. Among 410 consecutive penetrating keratoplasties performed at our institution, 79 grafts from 79 patients who developed signs of transplant rejection were i ncluded. Donor, recipient, surgical, and rejection variables were studied, at both univariate and multivariate levels. Results. The rate of reversibil ity was 51% (40/79). The average postoperative time of rejection was 10.5 /- 9.3 months, and the average time of visual acuity recovery in patients w ith reversible rejection was 2.4 +/- 2.3 months. In logistic regression, on ly two variables significantly influenced the rate of reversibility. The pr eoperative diagnosis (p = 0.04) influenced the rate of rejection reversibil ity;; patients with bullous keratopathy or regraft were mon likely to exper ience irreversible rejection than patients with keratoconus or Fuchs' dystr ophy. The average graft thickness at the lime of rejection diagnosis was 77 4 +/- 129 mum in patients with irreversible rejection and 681 +/- 118 mum i n patients with reversible rejection(p = 0.001). Conclusion. Rejection was reversible in half of the cases. Rejection was more likely to be irreversib le in patients with marked increase in graft thickness and in patients tran splanted for bullous keratopathy or graft failure. Donor variables did not influence rejection reversibility.