Corneal transplantation & graft failure

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Last staff update: 21 April 2021

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PubMed Search: Transplantation of cornea [title] pathology

Nat Pernick, M.D.
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Cite this page: Pernick N. Corneal transplantation & graft failure. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyecorneatransplant.html. Accessed September 29th, 2023.
Corneal transplantation
  • Keratoplasty (corneal transplantation):
    • Produces button 8 mm in diameter
  • Indications for keratoplasty:
    • Primary and secondary endothelial decompensation (dystrophy)
    • Fibrosis
    • Vascularization
    • Keratoconus
    • Failed prior grafts
    • Interstitial keratitis
  • Penetrating keratoplasty:
    • Full thickness corneal graft
    • 8 mm in diameter
  • Lamellar keratoplasty:
    • Partial thickness corneal graft
  • Donor corneal scleral rim:
    • Want to check for endothelial damage
Graft failure
  • Most corneal transplants are successful and provide long term improvement in visual acuity
  • Matching of donor and recipient tissue is not necessary for corneal transplants since no lymphatics or blood vessels in corneal stroma
  • Graft failure may be due to surgical damage of endothelium, immunologic rejection (uncommon) or recurrence of dystrophy
Microscopic (histologic) description
Graft failure:
  • Fibrosis, vascularization, inflammatory cell infiltrate
  • Full thickness scars from prior surgery are present at edge of specimen
  • 50% have fibrous retrocorneal membrane
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