TY - JOUR
T1 - Clinical and immunological results of corneal allograft rejection
AU - Smiddy, W. E.
AU - Stark, W. J.
AU - Young, E.
AU - Klein, P. E.
AU - Bias, W. D.
AU - Maumenee, A. E.
PY - 1986
Y1 - 1986
N2 - Of 111 episodes of graft rejection in 66 patients, 62 responded to therapy with graft clearing (responders); 49 did not (non-responders). Both groups were of similar age, sex, and etiology; both had a similar rate of glaucoma and a similar rate of previous grafting. In responders the graft reaction was shorter in duration (2.2 vs. 5.6 wks., p <0.005), and it was necessary to increase the number of glaucoma medications more often in non-responders compared to responders (41% vs. 19%, p <0.02). The interval from surgery to reaction was similar in responders and non-responders (18.2 vs. 13.3 mos., p >0.1). An epithelial rejection line was present in 11% of responders, but was not present in non-responders (p <0.05). Lymphocytotoxic antibody development correlated with rejection in 16 of 64 episodes. Patients who responded to treatment were more frequently asymptomatic (p <0.05) or were treated earlier following the onset of symptoms compared to non-responders (p <0.0001). These results suggest that, although graft rejection appears to be a more severe form of immunologic reactivity than graft reaction, there is no reproducible laboratory measure of any different basic immunologic mechanism. Clinically, however, reaction is more likely when an epithelial rejection line is present and when the duration of inflammatory activity is short.
AB - Of 111 episodes of graft rejection in 66 patients, 62 responded to therapy with graft clearing (responders); 49 did not (non-responders). Both groups were of similar age, sex, and etiology; both had a similar rate of glaucoma and a similar rate of previous grafting. In responders the graft reaction was shorter in duration (2.2 vs. 5.6 wks., p <0.005), and it was necessary to increase the number of glaucoma medications more often in non-responders compared to responders (41% vs. 19%, p <0.02). The interval from surgery to reaction was similar in responders and non-responders (18.2 vs. 13.3 mos., p >0.1). An epithelial rejection line was present in 11% of responders, but was not present in non-responders (p <0.05). Lymphocytotoxic antibody development correlated with rejection in 16 of 64 episodes. Patients who responded to treatment were more frequently asymptomatic (p <0.05) or were treated earlier following the onset of symptoms compared to non-responders (p <0.0001). These results suggest that, although graft rejection appears to be a more severe form of immunologic reactivity than graft reaction, there is no reproducible laboratory measure of any different basic immunologic mechanism. Clinically, however, reaction is more likely when an epithelial rejection line is present and when the duration of inflammatory activity is short.
UR - http://www.scopus.com/inward/record.url?scp=0023027069&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0023027069&partnerID=8YFLogxK
M3 - Article
C2 - 3540770
AN - SCOPUS:0023027069
VL - 17
SP - 644
EP - 649
JO - Ophthalmic Surgery and Lasers
JF - Ophthalmic Surgery and Lasers
SN - 2325-8160
IS - 10
ER -