Postkeratoplasty keratoconus nonkeratoconus patient

PURPOSE: To determine whether postkeratoplasty keratoconus is caused by a r ecurrence of the host disease or transferred from the donor. METHODS: Penetrating keratoplasty was performed on the right eye of a 73-ye ar-old woman with pseudophakic bullous keratopathy; her other eye was norma l. After keratoplasty, visual acuity decreased secondary to the appearance of irregular astigmatism, central corneal thinning, and stromal striae in t he graft, A repeat keratoplasty was performed, Clinical corneal topographic analysis and histopathologic studies were performed. RESULTS: Clinical findings and histopathology of the corneal graft were con sistent with keratoconus, The second graft has remained clear for 2 years w ithout signs of keratoconus, CONCLUSION: Classic keratoconus developed in a corneal graft in a patient w ithout preexisting keratoconus. This supports the theory that postkeratopla sty keratoconus may be secondary to transfer of the disease from the donor, (C) 2001 by Elsevier Science Inc. All rights reserved.