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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 7/2023

Open Access 21-01-2023 | Keratoplasty | Cornea

Recurrence of perforation and overall patient survival after penetrating keratoplasty versus amniotic membrane transplantation in corneal perforation

Authors: Carolin Elhardt, Romina Schweikert, Rupert Kamnig, Efstathios Vounotrypidis, Armin Wolf, Christian M. Wertheimer

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 7/2023

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Abstract

Purpose

The following is a comparative analysis on the treatment outcomes of corneal perforations using amniotic membrane transplantation (AMT) or penetrating keratoplasty (PK).

Methods

This monocentric retrospective study was performed at the Department of Ophthalmology, University Hospital Ulm, Germany. A total of 78 eyes of 78 patients were included. Thirty-nine eyes received an AMT, and 39 patients were treated with a PK. Primary outcome was recurrence of perforation. Secondary outcomes were patient mortality and visual acuity.

Results

No statistically significant difference was observed with regard to a recurrence of perforation between the two groups (26% in AMT vs 23% in PK, p > 0.99). The time of recurrences was within the first two years and did not differ statistically (p = 0.97). In addition, a proportional hazards model with cox regression regarding recurrent perforation showed no significant differences (p = 0.5). After AMT, 41% and after KP, 28% of the patients died during follow-up (p = 0.2), respectively. The Charlson Comorbidity Index (p < 0.0001) and the age at the time of surgery (p = 0.0002) were statistically significantly higher in those who were deceased. A mean follow-up of 485 ± 517 days was recorded.

Conclusion

Both surgical methods show good results and no statistically significant difference regarding recurrent perforation rate. About a third of the patients died during the follow-up period. The decision regarding the appropriate method should therefore be based on a combination of all factors.
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Metadata
Title
Recurrence of perforation and overall patient survival after penetrating keratoplasty versus amniotic membrane transplantation in corneal perforation
Authors
Carolin Elhardt
Romina Schweikert
Rupert Kamnig
Efstathios Vounotrypidis
Armin Wolf
Christian M. Wertheimer
Publication date
21-01-2023
Publisher
Springer Berlin Heidelberg
Keyword
Keratoplasty
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 7/2023
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-022-05914-0

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