Journal of the Korean Ophthalmological Society 2003;44(2):289-295.
Published online February 1, 2003.
Graft Rejection in Penetrating Keratoplasty.
Eun Chul Kim, Man Soo Kim
Department of Ophthalmology, College of Medicine, The Catholic university of Korea, Seoul, Korea. mskim@cmc.cuk.ac.kr
전층각막이식의 거부반응
김은철 ( Eun Chul Kim ) , 김만수 ( Man Soo Kim )
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.
Key Words: Graft rejection;Neovascularization;Penetrating keratoplasty


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