Immunologic graft reaction after allogenic penetrating keratoplasty

Risk Factors for the First Episode of Corneal Graft Rejection in Keratoconus

“…In the CTFS, the combined interrupted and continuous suture technique had reduced graft survival (from rejection and failure). 19 Patients in the CCTSs with the allinterrupted suture technique had a higher risk of failure (from rejection or any other cause). 18 Silbiger et al 10 found no correlation between suture techniques and rejection.…”

“…17 The CCTS authors thought that the surgeons used smaller grafts in patients who had other risk factors for rejection that were not included in their model. Jonas et al 16,19 found that the risk of a rejection episode was independent of graft size; however, the authors noted that the probable reason for the lack of a significant association may have been caused by the limited range of study patient graft size diameters. For keratoconus specifically, Silbiger et al, 10 in a previous study at our institution, found no correlation between rejection and donor size.…”

Indications and Results of Emergency Penetrating Keratoplasty With Simultaneous Cataract Surgery (“Triple-PKP à Chaud”)

“…43,44 On the other hand, suture loosening is another major factor influencing graft survival and inducing corneal neovascularization, infection, inflammation, and graft rejection. 41,42,45 In this study, both persistent epithelial defects (requiring AMT in 14 eyes, after initial/successful postoperative anti-infectious treatment) and suture loosening (12 eyes) were present early postoperatively, which may explain along with the other risk factors the poor graft survival of just 1 year on average. Early signs and a harbinger of early surface failure may include vortexing of sliding surface epithelium or demarcation of single sutures on fluorescein staining.…”

“…43,44 On the other hand, suture loosening is another major factor influencing graft survival and inducing corneal neovascularization, infection, inflammation, and graft rejection. 41,42,45…”

“…Regarding the postoperative course, corneal vascularization is one of the prognostic factors worsening the longterm success of PKP and may already exist preoperatively or develop after surgery. 41,42 On the one hand, neovascularization may occur due to prolonged epithelial healing disorders, which are often observed because of therapeutic PKP in infectious etiology. 43,44 On the other hand, suture loosening is another major factor influencing graft survival and inducing corneal neovascularization, infection, inflammation, and graft rejection.…”