Graft Rejection in Penetrating Keratoplasty

Kim, Eun Chul; Kim, Man Soo

Abstract

PURPOSE
To evaluate time, cause and frequency of graft rejection and age, visual acuity, endothelial cell count after penetrating keratoplasty (PKP). METHODS: Retrospectively we reviewed medical records of the patients who had undergone PKP between January 1994 and December 1996. Donor cornea was preserved with Optisol and we used 16 continuous and 8 interrupted suture technique with 10-0 nylon. RESULTS: Number of patients was 118 (male 95, female 23), and mean age was 43.77 18.03 years, and mean follow-up time was 40 months. Visual improvement over 2 Snellen chart lines was better in keratoconus (100%), corneal opacity of unknown etiology (75%), lipid keratopathy (75%), and corneal dystrophy (67%) than in graft failure and bullous keratopathy. Complication was graft failure (22 eyes), glaucoma (16 eyes), and corneal ulcer (3 eyes). Total graft rejection was 43 cases (37%), and rejection rate was hjgher in lipid keratopathy with neovascularization(NV) (50%), bullous keratopathy (45%), corneal ulcer (45%), graft failure (43.5%), and mean recovery time was 2-4 weeks, and recurrence of graft rejection was 11 cases (25%). The graft failure was most frequently associated with glaucoma and suture material irritation. Age distribution of graft rejection was high in the second decade (44%) and the first decade (41%), but low in the fifth decade (23.8%). CONCLUSIONS: Graft rejection was highest in young people during postoperative for to six months, the most common causes of graft rejection were glaucoma and suture material irritation and associated with corneal NV. There was significant endothelial cell loss after graft rejection.