Effects of penetrating keratoplasty rejection on the endothelium of the donor cornea and the recipient peripheral cornea

PURPOSE: To determine the effects of penetrating keratoplasty rejection on the recipient endothelium. METHODS: Twenty transplanted corneas of 20 keratoconus patients were enroll ed in this study. Ten of the corneas had undergone allograft rejection and the other 10 grafts had an uneventful postsurgical course. The endothelium of the donor cornea and the endothelium of the recipient peripheral cornea were evaluated by wide-field specular microscopy. RESULTS: The transplanted corneas that underwent allograft rejection showed a marked decrease in endothelial cell density not only in central donor co rnea but also in the recipient peripheral cornea compared with that in the uneventful transplanted corneas, Additionally, the recipient endothelium ha d significant pleomorphism in the rejection group. There were no morphologi c differences in the peripheral donor cornea between the control group and the rejection group. CONCLUSIONS: Our findings indicate that the recipient peripheral endotheliu m is also affected by allograft rejection, perhaps because of the contribut ion of recipient endothelium to the wound healing process after allograft r ejection. (Am J Ophthalmol 2000;129:468-471. (C) 2000 by Elsevier Science I nc. All rights reserved.).