Evaluation of serum neutrophil-to-lymphocyte ratio in corneal graft rejection after low-risk penetrating keratoplasty

Abstract

To evaluate systemic inflammatory parameters in patients with corneal graft rejection after low-risk penetrating keratoplasty. Patients undergoing penetrating keratoplasty with indications of keratoconus, pseudophakic bullous keratopathy, and Fuchs endothelial dystrophy were analyzed retrospectively. Patients who had an endothelial rejection attack within two years post-transplant were included in the rejection group (n\u2009=\u200920), whereas patients with at least two years of post-transplant follow-up without graft rejection or failure were included in the control group (n\u2009=\u200946). All patients’ clinical features and preoperative laboratory parameters were obtained from hospital records. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio, and platelet-to-lymphocyte ratio of the groups were calculated and compared. There was no difference between the two groups in terms of age, sex, indication, postmortem time and storage time of grafts, graft diameter, follow-up time, and common systemic diseases (p\u2009>\u20090.05). The NLR was found to be significantly lower in the rejection group when compared with the control group (2.04\u2009±\u20091.17, 2.66\u2009±\u20090.91, respectively, p\u2009=\u20090.023). There was no significant difference between the groups in terms of MLR and PLR (p\u2009=\u20090.243, p\u2009=\u20090.101, respectively). Although a high NLR value, which is an indicator of systemic inflammatory condition, is associated with many ocular diseases, NLR was found to be lower in patients with a rejection episode after transplant surgery when compared with the control group. Further studies are needed to clarify the role of these hematologic parameters in graft rejection.