April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Observation of Corneal Graft-Host Malapposition after Penetrating Keratoplasty for Keratoconus by AS-OCT
Author Affiliations & Notes
  • JianJiang Xu
    Ophthalmology, EYE & ENT Hospital of Fudan Univ, Shanghai, China
  • Hong Zhuang
    Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
  • Jiaxu Hong
    Ophthalmology, Eye & Ear, Nose, Throat Hospital, Shanghai, China
  • Footnotes
    Commercial Relationships  JianJiang Xu, None; Hong Zhuang, None; Jiaxu Hong, None
  • Footnotes
    Support  Ministry of Health Grant (2010-2013); Shanghai Municipality Grant (10XD1401100); Fudan University Grant (2009-2011).
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 367. doi:
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      JianJiang Xu, Hong Zhuang, Jiaxu Hong; Observation of Corneal Graft-Host Malapposition after Penetrating Keratoplasty for Keratoconus by AS-OCT. Invest. Ophthalmol. Vis. Sci. 2011;52(14):367.

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      © ARVO (1962-2015); The Authors (2016-present)

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To observe configuration of graft-host (GH) apposition after penetrating keratoplasty (PKP) for keratoconus using anterior segment OCT (AS-OCT).


Retrospective case series study. 23 patients (24 eyes) with keratoconus after PKP were involved in this study, and all of them had removed sutures. The examinations included slit-lamp microscopy, manifest refraction, corneal topography and AS-OCT. The mode of "high resolution corneal 4-lines at 45°apart " was selected in AS-OCT exam, so that eight optical sections of GH junction on 4 axes were acquired from each eye. Classification of GH malappositions and their severity were determined, and size of GH touch was measured.


Although all of 192 GH sections from 24 eyes had continuous smooth epithelial surface, 138 sections of them had internal GH malapposition including "Graft Step" (52), "Host Step" (28), "Hill Protrusion" (34), "Tag Protrusion" (11), and "Gape" (13). Internal Step and Gape significantly reduced GH touch, while Hill Protrusion significantly increased GH touch. LogMAR best corrected visual acuity (BCVA) (rs = 0.5421, P = 0.0062), Corneal astigmatism (rs = 0.7816, P = 0.0000) and corneal irregularity measure (CIM) (rs = 0.5596, P=0.0045) were all significantly correlated with severity of GH malapposition. Moreover, spherical equivalent (rs = 0.5271, P = 0.0081) and semi-meridian keratometry on the same direction (rs = -0.4358, P = 0.0000) were both significantly correlated with size of GH touch.


Our study with AS-OCT found internal GH malappositions were common after PKP in patients with keratoconus, and internal malappositions were closely associated with postoperational irregular astigmatism that limited improvement in visual function. Therefore, more attention should be paid to internal GH apposition in PKP.  

Keywords: cornea: clinical science • wound healing • transplantation 

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