2010 OMIG, Abstract 21

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The role of atopy in penetrating corneal graft survival and rejection in keratoconus
J.K. Thomas, A. Guel, H.D. Cavanagh, University of Texas Southwestern Medical Center at Dallas,   Dept. of Ophthalmology, Dallas, TX

Purpose: To assess the role of atopy in penetrating corneal graft survival and rejection in keratoconus.
Methods: The records of patients receiving penetrating keratoplasty (PK) for keratoconus between 1988-2009 at the University of Texas Southwestern (UTSW) Medical Center were reviewed for a history of atopic disorders including asthma, allergic rhinitis, allergic conjunctivitis, atopic keratoconjunctivitis (AKC) and eczema.  The Kaplan-Meier method was used to compare corneal graft survival in patients with and without a clinical history of atopy.  The Fisher’s exact test was used to compare categorical data. The Student’s t-test was used to compare mean values.
Results: There were 168 grafts in 122 patients; a clinical history of atopy was present in 66 (39.2%).  The mean age was 39.12years±12.3years.  There were 93(57.4%) and 75(44.6%) males and females, respectively.  Males without a history of atopy received first grafts significantly more frequently than females (p=0.029).  No gender difference was noted in patients receiving multiple grafts. No statistically significant difference existed with regard to age and duration of average follow up between the atopic and nonatopic groups.  There were 20 (30.4%) and 32 (31.3%) cases of allograft rejection in the atopic and nonatopic groups, respectively.  This difference was not statistically significant (p=1.000).  There were 15 graft failures, 6 and 9 in the atopic and nonatopic groups respectively.  The most common cause of graft failure in both groups was immunologic rejection.  The nonatopic group had 2 failed grafts from postoperative fungal keratitis.  Graft survival among those with and without a clinical history of atopy did not differ significantly in the first (p=0.881), second (p=0.752) or three or more grafts groups (p=.157).  Among those with a history of atopy, no statistically significant difference in survival was found between patients analyzed with separate components of the atopic spectrum (p=0.061). A history of one episode of allograft rejection created a statistically significant difference in ultimate graft survival in both the atopic (p=0.003) and nonatopic (p=0.002) groups. 
Conclusion: In keratoconus patients undergoing penetrating keratoplasty, a clinical history of atopy does not provide a statistically significant difference in graft rejection or survival in comparison to patients without a history of atopy.  Furthermore, among those with a history of atopy, no statistically significant difference in survival was noted between those with separate components of the atopic spectrum.
Disclosure code: N