Our findings show that endothelial changes in imported donor corneas do occur after transportation, but the surgical success rate may not be influenced significantly if the penetrating keratoplasty is performed within 7 days after donor death. However, the ECD in the clear grafts 4 years after surgery is low.

We conducted a corneal epithelial permeability study using a fluorophotometer on 93 eyes of 79 patients with clear corneal grafts. There were 45 males and 34 females, aged 61.6 ± 10.2 years. All eyes received penetrating keratoplasty at least 1 year (mean 40.4 ± 31.3 months) before examination. The normal fellow eyes of 65 subjects were examined as controls. The averaged corneal epithelial permeability of grafted corneas was significantly higher than that of controls (p < 0.001). In the 65 individuals having an otherwise healthy fellow eye, the grafted corneas were significantly more permeable than their control fellow eyes verified by paired t test (n = 65, p = 0.006). Concomitant corneal sensitivity test revealed a significantly hypesthetic cornea. These results show that in spite of a clinically normal clear graft, there is usually a subnormal epithelial barrier function and reinnervation, even years after comeal transplantation.