Original articleCorneal Neovascularization as a Risk Factor for Graft Failure and Rejection after Keratoplasty: An Evidence-Based Meta-analysis
Section snippets
Materials and Methods
The study was undertaken in accord with both the Cochrane Collaboration methods for systematic reviews and previous meta-analyses of surrogate outcomes.9, 10, 11
Identification and Selection of Studies
More than 4415 titles were retrieved from the various search sources, and 43 full articles were identified for possible inclusion. Full articles were excluded for a number of reasons: multiple registry or cohort report (8 articles), no measure of association reported (8 articles), patients undergoing repeated grafting (1 article), and no neovascularization outcome and no graft failure or rejection outcome (4 articles). In total, 19 eligible studies (22 publications) remained.
Study Characteristics and Quality
The 19 studies
Discussion
The current systematic review of 19 studies comprising 24 944 keratoplasties allows several important conclusions to be drawn. First, there exists a strong association between loss of corneal angiogenic privilege, i.e., pathologic CNV, and increased risk for graft failure with a pooled hazard ratio of 1.32 (95% CI, 1.15–1.49). Second, in addition and in contrast to the Collaborative Corneal Transplantation Study data,2 there was evidence of an association between CNV and graft rejection after
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Cited by (0)
Manuscript no. 2009-807.
Financial Disclosure(s): The author(s) have made the following disclosure(s):
Rod S. Taylor - Consultant - Gene Signal
Claus Cursiefen - Consultant - Gene Signal
Supported by the Interdisciplinary Center for Clinical Research Erlangen, Erlangen, Germany; the German Research Foundation (SFB 643), Bonn, Germany; and GeneSignal, Evry (Paris), France. Gene Signal, France, funded the study. The planning of this study, interpretation of findings, and writing and conclusions of manuscript were undertaken entirely independently of the company interests.