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Abstract：
OBJECTIVE: This study aims to describe the outcome of corneal grafts, both low risk and high risk, after successfully reversed immunological rejection.
METHODS: Datasets on reversed rejection episodes in penetrating and endothelial keratoplasties between 2014 and 2019 (n=876) were extracted from the Adverse Immune Signatures and their Prevention in Corneal Transplantation database, which contains the prospectively and consecutively collected corneal transplants from five European centres. Stratified by the preoperatively determined risk status for immunological rejection, the outcome parameters analysed included visual acuity, intraocular pressure, endothelial cell density and central corneal thickness before and after reversed rejection episodes.
RESULTS: Fourty-seven (52%) out of a total of 91 identified rejection episodes were successfully reversed and were available for analysis (23 penetrating and 24 endothelial keratoplasties). No statistically significant change was found for any of the parameters studied between the values before and the values 3 months after the rejection episode, irrespective of the preoperative risk status.
CONCLUSIONS: The outcome of corneal grafts that survive immunological rejection may be clinically indistinguishable from the state before immunological rejection, irrespective of graft type and risk status. These findings support clinicians by providing information on prognosis after reversed rejection episodes and by giving patients realistic expectations regarding the outcome.
METHODS: Datasets on reversed rejection episodes in penetrating and endothelial keratoplasties between 2014 and 2019 (n=876) were extracted from the Adverse Immune Signatures and their Prevention in Corneal Transplantation database, which contains the prospectively and consecutively collected corneal transplants from five European centres. Stratified by the preoperatively determined risk status for immunological rejection, the outcome parameters analysed included visual acuity, intraocular pressure, endothelial cell density and central corneal thickness before and after reversed rejection episodes.
RESULTS: Fourty-seven (52%) out of a total of 91 identified rejection episodes were successfully reversed and were available for analysis (23 penetrating and 24 endothelial keratoplasties). No statistically significant change was found for any of the parameters studied between the values before and the values 3 months after the rejection episode, irrespective of the preoperative risk status.
CONCLUSIONS: The outcome of corneal grafts that survive immunological rejection may be clinically indistinguishable from the state before immunological rejection, irrespective of graft type and risk status. These findings support clinicians by providing information on prognosis after reversed rejection episodes and by giving patients realistic expectations regarding the outcome.
摘要：
目的：本研究旨在描述角膜移植的结果，低风险和高风险，在成功逆转免疫排斥反应后。
方法：从角膜移植数据库中的不良免疫特征及其预防中提取了2014年至2019年之间穿透性和内皮性角膜移植术中逆转排斥事件的数据集（n=876），其中包含来自五个欧洲中心的前瞻性和连续收集的角膜移植。按术前确定的免疫排斥反应的风险状态进行分层，分析的结果参数包括视力，眼内压,逆转排斥前后的内皮细胞密度和中央角膜厚度。
结果：总共91次确定的排斥反应中，有47次（52%）成功逆转，可用于分析（23次穿透性和24次内皮性角膜移植术）。在排斥事件发生前的值和3个月后的值之间，未发现任何研究参数有统计学意义的变化。与术前风险状况无关。
结论：在免疫排斥中存活的角膜移植物的结果可能在临床上与免疫排斥前的状态没有区别，与移植物类型和风险状态无关。这些发现通过提供逆转排斥事件后的预后信息并给予患者对结果的现实期望来支持临床医生。
方法：从角膜移植数据库中的不良免疫特征及其预防中提取了2014年至2019年之间穿透性和内皮性角膜移植术中逆转排斥事件的数据集（n=876），其中包含来自五个欧洲中心的前瞻性和连续收集的角膜移植。按术前确定的免疫排斥反应的风险状态进行分层，分析的结果参数包括视力，眼内压,逆转排斥前后的内皮细胞密度和中央角膜厚度。
结果：总共91次确定的排斥反应中，有47次（52%）成功逆转，可用于分析（23次穿透性和24次内皮性角膜移植术）。在排斥事件发生前的值和3个月后的值之间，未发现任何研究参数有统计学意义的变化。与术前风险状况无关。
结论：在免疫排斥中存活的角膜移植物的结果可能在临床上与免疫排斥前的状态没有区别，与移植物类型和风险状态无关。这些发现通过提供逆转排斥事件后的预后信息并给予患者对结果的现实期望来支持临床医生。
