Recurrent keratoconus: an analysis of breaks in Bowman’s layer in corneal grafts
Objective To study in a masked fashion whether an objective histological feature associated with keratoconus (KCN) occurs in donor corneas in eyes originally receiving a corneal graft for KCN.Methods Two ocular pathologists performed a retrospective masked histological analysis of slides from donor...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open Ophthalmology |
| Online Access: | https://bmjophth.bmj.com/content/8/1/e001225.full |
| _version_ | 1797367647135858688 |
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| author | Pia Leon David Zurakowski Joseph B Ciolino Thaddeus P Dryja Lynette K Johns Paula Cortes-Barrantes Mehenaz Hanbazazh |
| author_facet | Pia Leon David Zurakowski Joseph B Ciolino Thaddeus P Dryja Lynette K Johns Paula Cortes-Barrantes Mehenaz Hanbazazh |
| author_sort | Pia Leon |
| collection | DOAJ |
| description | Objective To study in a masked fashion whether an objective histological feature associated with keratoconus (KCN) occurs in donor corneas in eyes originally receiving a corneal graft for KCN.Methods Two ocular pathologists performed a retrospective masked histological analysis of slides from donor buttons recovered from 21 eyes with a history of KCN undergoing repeat penetrating keratoplasty (failed-PK-KCN), 11 eyes that underwent their first PK due to KCN (primary KCN), and 11 eyes without history of KCN which underwent PK for other conditions (failed-PK-non-KCN). Breaks/gaps in Bowman’s layer served as the pathological feature indicative of recurrent KCN.Results Breaks in Bowman’s layer were present in 18/21 (86%) of the failed-PK-KCN group, 10/11 (91%) of the primary KCN group, and in 3/11 (27%) of the failed-PK-non-KCN group. Pathological evidence suggests that the prevalence of breaks is significantly higher in grafted patients with a history of KCN than non-KCN controls (OR: 16.0, 95% CI 2.63 to 97.2, Fisher’s exact test p=0.0018) with a conservative Bonferroni criterion of p <0.017 to account for multiple group comparisons. There was no statistically significant difference found between the failed-PK-KCN and primary KCN groups.Conclusions This study provides histological evidence that breaks and gaps in Bowman’s layer, consistent with those found in primary KCN, may develop within the donor tissue in eyes with a history of KCN. |
| first_indexed | 2024-03-08T17:21:16Z |
| format | Article |
| id | doaj.art-ebd6ae3c085a4da79958f3c002115a44 |
| institution | Directory Open Access Journal |
| issn | 2397-3269 |
| language | English |
| last_indexed | 2024-03-08T17:21:16Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Ophthalmology |
| spelling | doaj.art-ebd6ae3c085a4da79958f3c002115a442024-01-03T06:00:07ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692023-12-018110.1136/bmjophth-2022-001225Recurrent keratoconus: an analysis of breaks in Bowman’s layer in corneal graftsPia Leon0David Zurakowski1Joseph B Ciolino2Thaddeus P Dryja3Lynette K Johns4Paula Cortes-Barrantes5Mehenaz Hanbazazh6Ospedale SS Giovanni e Paolo Venezia, Venezia, ItalyDepartments of Anesthesiology and Surgery, Boston Children`s Hospital, Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USADepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USADepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USADepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USADepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USADepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USAObjective To study in a masked fashion whether an objective histological feature associated with keratoconus (KCN) occurs in donor corneas in eyes originally receiving a corneal graft for KCN.Methods Two ocular pathologists performed a retrospective masked histological analysis of slides from donor buttons recovered from 21 eyes with a history of KCN undergoing repeat penetrating keratoplasty (failed-PK-KCN), 11 eyes that underwent their first PK due to KCN (primary KCN), and 11 eyes without history of KCN which underwent PK for other conditions (failed-PK-non-KCN). Breaks/gaps in Bowman’s layer served as the pathological feature indicative of recurrent KCN.Results Breaks in Bowman’s layer were present in 18/21 (86%) of the failed-PK-KCN group, 10/11 (91%) of the primary KCN group, and in 3/11 (27%) of the failed-PK-non-KCN group. Pathological evidence suggests that the prevalence of breaks is significantly higher in grafted patients with a history of KCN than non-KCN controls (OR: 16.0, 95% CI 2.63 to 97.2, Fisher’s exact test p=0.0018) with a conservative Bonferroni criterion of p <0.017 to account for multiple group comparisons. There was no statistically significant difference found between the failed-PK-KCN and primary KCN groups.Conclusions This study provides histological evidence that breaks and gaps in Bowman’s layer, consistent with those found in primary KCN, may develop within the donor tissue in eyes with a history of KCN.https://bmjophth.bmj.com/content/8/1/e001225.full |
| spellingShingle | Pia Leon David Zurakowski Joseph B Ciolino Thaddeus P Dryja Lynette K Johns Paula Cortes-Barrantes Mehenaz Hanbazazh Recurrent keratoconus: an analysis of breaks in Bowman’s layer in corneal grafts BMJ Open Ophthalmology |
| title | Recurrent keratoconus: an analysis of breaks in Bowman’s layer in corneal grafts |
| title_full | Recurrent keratoconus: an analysis of breaks in Bowman’s layer in corneal grafts |
| title_fullStr | Recurrent keratoconus: an analysis of breaks in Bowman’s layer in corneal grafts |
| title_full_unstemmed | Recurrent keratoconus: an analysis of breaks in Bowman’s layer in corneal grafts |
| title_short | Recurrent keratoconus: an analysis of breaks in Bowman’s layer in corneal grafts |
| title_sort | recurrent keratoconus an analysis of breaks in bowman s layer in corneal grafts |
| url | https://bmjophth.bmj.com/content/8/1/e001225.full |
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