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Cornea & External Diseases

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Surgery & Complications
Primary graft failure with permanent corneal edema.

  • Occurs when the donor cornea doesn't retain the transparency sufficient for adequate vision. The most common cause is endothelial cells dysfunction.
  • Other causes include sub-optimal condition of donor tissue, intraocular inflammation, hypotony due to ciliary body dysfunction in a traumatized eye, endothelial trauma during surgery, vitreous or iris tissue adherence to endothelium and preexisting glaucoma.
  • Clinical features
    • Symptoms: hazy or blurred vision
    • Uncommon complication of penetrating keratoplasty.
    • Hazy and graft thickening associated with microcystic edema and multiple stromal or Descemet's folds.
  • Management:
    • Intensive instillation of topical steroids around the clock to diminish inflammation.
    • Regrafting in cases with persistent corneal edema.
    • Donor button should be sent for pathologic evaluation.

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