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The effect of topical autologous serum on graft re-epithelialization after penetrating keratoplasty.

Abstract：

PURPOSE:To analyze factors influencing corneal graft re-epithelialization after penetrating keratoplasty (PK) and evaluate the effect of topical autologous serum in promoting graft re-epithelialization. DESIGN:Prospective interventional study. METHODS:We analyzed 165 eyes of 165 patients who underwent PK between January 1, 2005 and December 31, 2007. Patients were divided into 2 groups according to routine use or non-use of postoperative 20% topical autologous serum. Postoperative slit-lamp examination after fluorescein staining was performed, and graft re-epithelialization time was recorded. Recipient/donor characteristics, surgical variables, and topical use of autologous serum were analyzed for their effects on post-PK graft re-epithelialization. Statistical analysis was performed by univariate and multivariate regression analysis using the ordinal logistic fit model to assess the potential risk factors influencing graft re-epithelialization after PK. RESULTS:In univariate analysis, diabetes mellitus (DM), longer death-to-storage time and death-to-surgery time of the donor, and larger recipient size significantly delayed graft re-epithelialization (P < .05). Use of autologous serum significantly expedited graft re-epithelialization (P = .004). In multiple regression analysis, only DM in the recipient (odds ratio [OR] = 5.10, P < .001), postoperative use of autologous serum (OR = 0.54, P = .046), and larger graft size (OR = 4.44, P < .001) influenced graft re-epithelialization. The beneficial and healing effect of autologous serum is particularly significant in diabetic recipients and larger grafts. CONCLUSIONS:Several factors may influence graft re-epithelialization after PK. Graft re-epithelialization time was longer in diabetic recipients and larger grafts. Use of autologous serum may be a beneficial strategy in these patients with potentially delayed epithelial healing.

journal_name

Am J Ophthalmol

journal_title

American journal of ophthalmology

authors

Chen YM,Hu FR,Huang JY,Shen EP,Tsai TY,Chen WL

doi

10.1016/j.ajo.2010.03.024

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

352-359.e2

issue

3

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(10)00249-7

journal_volume

150

pub_type

杂志文章

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