Factors Influencing Pseudophakic Corneal Rejection

Abstract

Purpose: To evaluate factors that may influence corneal rejection in patients with chronic pseudophakic corneal edema operated with penetrating keratoplasty or protected penetrating keratoplasty.

Methods: A descriptive cross-sectional study was performed in patients with chronic pseudophakic corneal edema, who were treated by two different techniques: penetrating keratoplasty or protected penetrating keratoplasty. A non-probabilistic, purposive sampling was used, and sociodemographic variables, surgical techniques and postoperative complications were analyzed.

Results: Age older than 75 years and intraocular lens extraction were the factors that were significantly associated with the incidence of post-rejection opacity (p < 0.032 and p < 0.046, respectively). The following postoperative complications occurred in four cases: keratitis, suture dehiscence, postoperative glaucoma, and age-related macular degeneration, the latter only in the group operated by penetrating keratoplasty. There was no association between complications and post-rejection opacity (p = 1.000). In the protected penetrating keratoplasty group there were no cases with post-rejection opacity, while in the penetrating keratoplasty group nine were found.

Conclusions: Advanced age and intraocular lens extraction were shown to be the factors influencing corneal rejection in patients with chronic pseudophakic corneal edema, especially in those operated with penetrating keratoplasty. Protective penetrating keratoplasty reduces or minimizes corneal rejection in patients with chronic pseudophakic corneal edema.