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Corneal neovascularisation following deep anterior lamellar keratoplasty for corneal ectasia: incidence, timing and risk factors
  1. Marco Pellegrini1,2,
  2. Vincenzo Scorcia3,
  3. Giuseppe Giannaccare3,
  4. Andrea Lucisano3,
  5. Sabrina Vaccaro3,
  6. Caterina Battaglia3,
  7. Angeli Christy Yu1,2,4,
  8. Cristina Bovone1,2,4,
  9. Massimo Busin1,2,4,
  10. Rossella Spena1,2,4
  1. 1Ospedali Privati Forlì “Villa Igea”, Department of Ophthalmology, Forlì, Italy
  2. 2Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy
  3. 3Department of Ophthalmology, Magna Graecia University of Catanzaro, Catanzaro, Italy
  4. 4University of Ferrara, Department of Translational Medicine, Ferrara, Italy
  1. Correspondence to Dr Rossella Spena, Department of Translational Medicine, University of Ferrara, Ferrara 47122, Italy; rossespena{at}gmail.com

Abstract

Background The purpose of this study was to evaluate the incidence, timing and risk factors of corneal neovascularisation (NV) after deep anterior lamellar keratoplasty (DALK) for corneal ectasia.

Methods This study included 616 eyes who underwent DALK between 2012 and 2020 in two tertiary referral centres. In one centre topical corticosteroids were discontinued after complete suture removal 1 year after surgery, whereas in the other they were discontinued 3–4 months after surgery. The presence and severity of corneal NV was ascertained based on slit lamp photographs. Potential risk factors for corneal NV were evaluated using the Cox proportional hazards model.

Results The cumulative incidence of corneal NV was 8.7% at 1 year after surgery and 13.2% at 5 years. Mean time interval from surgery to development of corneal NV was 12.8±16.2 months, with 68.9% of cases occurring before complete suture removal. Early discontinuation of topical steroids, older age and ocular allergy were associated with an increased risk of developing corneal NV (respectively, HR=2.625, HR=1.019, HR=3.726, all p<0.05).

Conclusions The risk of corneal NV is higher in the first year following DALK. Early discontinuation of topical steroids, ocular allergy and older age are significant predictors of corneal NV.

  • neovascularisation
  • cornea
  • treatment surgery

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information

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Footnotes

  • MP and VS contributed equally.

  • Contributors Concept and design of the study: MP, VS and MB. Data acquisition: VS, GG, AL, SV, CB and RS. Data analysis/interpretation: MP, VS, ACY and MB. Drafting the manuscript: MP, VS, GG, ACY and MB. Critical revision of manuscript: VS, MB and RS. Statistical analysis: MP and ACY. Final approval: MP, VS, GG, AL, SV, CB, ACY, CB, MB and RS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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