Corneal transplantation after failed grafts: Options and outcomes

Corneal transplantation is the most commonly performed human tissue transplantation procedure worldwide. Because of the large number of transplants, corneal graft failure has become one of the most common indications for corneal transplantation. The relatively recently developed lamellar transplant...

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Bibliographic Details
Published in:Survey of ophthalmology 2021-01, Vol.66 (1), p.20-40
Main Authors: Alió del Barrio, Jorge L., Bhogal, Maninder, Ang, Marcus, Ziaei, Mohammed, Robbie, Scott, Montesel, Andrea, Gore, Daniel M., Mehta, Jodhbir S., Alió, Jorge L.
Format: Article
Language:English
Subjects:
cornea
Corneal Diseases - surgery
corneal graft
Corneal Transplantation - methods
DALK
DMEK
ectasia
endothelial keratoplasty
failure
Humans
keratoconus recurrence
keratoplasty
Keratoplasty, Penetrating - adverse effects
Keratoplasty, Penetrating - methods
lamellar keratoplasty
penetrating keratoplasty
Postoperative Complications - epidemiology
repeat keratoplasty
Retrospective Studies
Vision Disorders
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Summary:Corneal transplantation is the most commonly performed human tissue transplantation procedure worldwide. Because of the large number of transplants, corneal graft failure has become one of the most common indications for corneal transplantation. The relatively recently developed lamellar transplant techniques have brought about specific potential complications leading to graft failure that may require different approaches to repeat transplantation other than penetrating keratoplasty. On the other hand, these new lamellar techniques also provide novel ways of rescuing failed penetrating grafts, with potential advantages over successive penetrating keratoplasties, such as reduced intraoperative risks and faster visual rehabilitation. We summarize the incidence and risk factors of graft failure for penetrating and lamellar (stromal and endothelial) corneal transplants and discuss the various surgical alternatives currently available to rescue such failed grafts, with a focus on the reported outcomes and limitations.
ISSN:0039-6257
1879-3304
DOI:10.1016/j.survophthal.2020.10.003