Klin Monbl Augenheilkd
DOI: 10.1055/a-1353-6149
Klinische Studie

Survey of Rejection Prophylaxis Following Suture Removal in Penetrating Keratoplasty in Germany

Article in several languages: English | deutsch
Sonja Heinzelmann
1  Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland
,
Daniel Böhringer
1  Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland
,
Philip Christian Maier
1  Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland
,
2  Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Homburg (Saar), Deutschland
,
Claus Cursiefen
3  Zentrum für Augenheilkunde, Universitätsklinikum Köln, Deutschland
,
Anna-Karina B. Maier
4  Klinik für Augenheilkunde, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
Tina Dietrich-Ntoukas
4  Klinik für Augenheilkunde, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
Gerd Geerling
5  Augenklinik, Universitätsklinikum Düsseldorf, Deutschland
,
Arne Viestenz
6  Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle (Saale), Deutschland
,
Norbert Pfeiffer
7  Augenklinik und Poliklinik, Universitätsmedizin Mainz, Deutschland
,
Thomas Reinhard
1  Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Deutschland
› Author Affiliations

Abstract

Background Penetrating keratoplasty (PK) gets more and more reserved to cases of increasing complexity. In such cases, ocular comorbidities may limit graft survival following PK. A major cause for graft failure is endothelial graft rejection. Suture removal is a known risk factor for graft rejection. Nevertheless, there is no evidence-based regimen for rejection prophylaxis following suture removal. Therefore, a survey of rejection prophylaxis was conducted at 7 German keratoplasty centres.

Objective The aim of the study was documentation of the variability of medicinal aftercare following suture removal in Germany.

Methods Seven German keratoplasty centres with the highest numbers for PK were selected. The centres were sent a survey consisting of half-open questions. The centres performed a mean of 140 PK in 2018. The return rate was 100%. The findings were tabulated.

Results All centres perform a double-running cross-stitch suture for standard PK, as well as a treatment for rejection prophylaxis with topical steroids after suture removal. There are differences in intensity (1 – 5 times daily) and tapering (2 – 20 weeks) of the topical steroids following suture removal. Two centres additionally use systemic steroids for a few days.

Discussion Rejection prophylaxis following PK is currently poorly standardised and not evidence-based. All included centres perform medical aftercare following suture removal. It is assumed that different treatment strategies show different cost-benefit ratios. In the face of the diversity, a systematic analysis is required to develop an optimised regimen for all patients.



Publication History

Received: 19 November 2020

Accepted: 28 December 2020

Publication Date:
25 February 2021 (online)

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