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Surgery & Complications
Epithelial Rejection Line

  • Clinical features:
    • Average time to onset of rejection is 3 months.
    • Symptoms: usually asymptomatic or minimal symptoms of irritation or blurry vision.
    • Signs: elevated linear opacity in transplanted cornea across graft surface, which advances centrally over the course of several days.
    • Usually self-limited.
  • In this patient, the first appearance of the rejection line was 20 months after a combined allograft lamellar keratoplasty and limbal transplantation for severe corneal scarring following a chemical burn.
  • Treatment: topical steroids are indicated because epithelial rejection may be a precursor to a more serious endothelial rejection.

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