Development of a Nomogram to Predict Graft Survival After Descemet Stripping Endothelial Keratoplasty

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dc.contributor.authorCherkas, Elliot
dc.contributor.authorCinar, Yasin
dc.contributor.authorZhang, Qiang
dc.contributor.authorSharpe, James
dc.contributor.authorHammersmith, Kristin M. M.
dc.contributor.authorNagra, Parveen K. K.
dc.contributor.authorRapuano, Christopher J. J.
dc.date.accessioned2024-04-24T17:08:17Z
dc.date.available2024-04-24T17:08:17Z
dc.date.issued2023
dc.departmentDicle Üniversitesien_US
dc.description.abstractBackground/Purpose:The purpose of this study was to analyze Descemet stripping endothelial keratoplasty (DSEK) outcomes and develop a nomogram to compute the probability of 3- and 5-year DSEK graft survival based on risk factors.Study Design/Methods:The medical records of 794 DSEK procedures between January 1, 2008, and August 1, 2019, were retrospectively reviewed to identify 37 variables. We also evaluated for the presence of corneal graft failure, defined as irreversible and visually significant graft edema, haze, or scarring. Variables were assessed by multivariable Cox models, and a nomogram was created to predict the probability of 3- and 5-year graft survival.Results:Graft failure occurred in 80 transplants (10.1%). The strongest risk factors for graft failure included graft detachment [hazard ratio (HR) = 4.46; P < 0.001], prior glaucoma surgery (HR = 3.14; P = 0.001), and glaucoma (HR = 2.23; P = 0.018). A preoperative diagnosis of Fuchs dystrophy was associated with a decreased risk of graft failure (HR = 0.47; P = 0.005) compared with secondary corneal edema. Our nomogram has a concordance index of 0.75 (95% confidence interval, 0.69 to 0.81), which indicates that it may predict the probability of graft survival at 3 and 5 years with reasonable accuracy. We also analyzed graft rejection, which occurred in 39 cases (4.9%). The single risk factor found to be significantly associated with graft rejection was prior glaucoma surgery (HR = 2.87; P = 0.008).Conclusions:Our nomogram may accurately predict DSEK graft survival after 3 and 5 years based on 4 variables. This nomogram will empower surgeons to share useful data with patients and improve collective clinical decision-making.en_US
dc.description.sponsorshipBNY Mellon Elizabeth C. King Trusten_US
dc.description.sponsorshipSupported by the BNY Mellon Elizabeth C. King Trust.en_US
dc.identifier.doi10.1097/ICO.0000000000002958
dc.identifier.endpage26en_US
dc.identifier.issn0277-3740
dc.identifier.issn1536-4798
dc.identifier.issue1en_US
dc.identifier.pmid34935664
dc.identifier.scopus2-s2.0-85143379913
dc.identifier.scopusqualityQ1
dc.identifier.startpage20en_US
dc.identifier.urihttps://doi.org/10.1097/ICO.0000000000002958
dc.identifier.urihttps://hdl.handle.net/11468/17282
dc.identifier.volume42en_US
dc.identifier.wosWOS:000926479700004
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofCornea
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectDseken_US
dc.subjectGraft Failureen_US
dc.subjectGraft Survivalen_US
dc.subjectNomogramen_US
dc.titleDevelopment of a Nomogram to Predict Graft Survival After Descemet Stripping Endothelial Keratoplastyen_US
dc.titleDevelopment of a Nomogram to Predict Graft Survival After Descemet Stripping Endothelial Keratoplasty
dc.typeArticleen_US

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