High risk corneal grafting
- Department of Ophthalmology, University of Cape Town and Groote Schuur Hospital, Capetown, South Africa; johnhill@iafrica.com
Special precautions need to be taken to prevent or minimise rejection
With improvements in technology we can expect the number of corneal grafts to decrease. Modern lens implant design, viscoelastic materials, and improved antimicrobial agents have all made an impact in this respect. But the need for keratoplasty remains and with it the vexing problem of how to deal with the “high risk” cornea.
The cornea has long been recognised as having “immunological privilege” but in vascularised corneas and possibly corneas that have previously rejected a graft, this privilege breaks down and the cornea becomes as susceptible as any other vascularised tissue in the body to rejection. These corneas have been referred to as “high risk” and special precautions need to be taken to prevent or minimise rejection. When attempting to establish the optimal treatment for these corneas, the first hurdle remains the definition of a “high risk” cornea. This question has …
