Risk Factors for Fibrous Ingrowth in Eyes Requiring Primary Keratoplasty
David A. Ramirez, Abigail L. Walling, Christopher R. Fortenbach, Emily Witsberger, Kendra Frey, Lai Jiang, Nasreen A. Syed, M. Bridget Zimmerman, Mark A. Greiner, Christopher S. Sales- Ophthalmology
Purpose:
The aim of this study was to define risks for corneal transplantation associated with fibrous ingrowth among first-time transplant recipients.
Methods:
We performed a retrospective case–control study of patients with a histopathologic diagnosis of fibrous ingrowth between 2002 and 2019. Patients with fibrous ingrowth from a first corneal specimen were included. Those with incomplete records were excluded. A 1:2 case–control ratio was used. Controls were matched using surgical indication, surgery year, transplantation method, sex, and age.
Results:
Seventy-eight eyes (76 patients) were included and matched with 160 control eyes. The incidence of fibrous ingrowth found on a first corneal transplant was 0.6% per year. The most common keratoplasty indications were pseudophakic corneal edema (n = 25, 32%) and aphakic corneal edema (n = 15, 19%). Cases were more likely to have a history of ocular trauma (odds ratio [OR], 2.94; 95% CI, 1.30–6.30;
Conclusions:
A history of ocular trauma, uveitis, retinal detachment or previous retinal surgery, glaucoma tube-shunt surgery, aphakia, and iris derangement are risks for detecting fibrous ingrowth among first-time keratoplasty recipients. Patients with these conditions should be monitored closely for corneal decompensation.