Abstract
Presentation Description :
Immune reactions after corneal transplantation have decreased significantly after the widespread introduction of lamellar grafting techniques. Endothelial rejection is the principal cause of graft failure after normal-risk penetrating keratoplasty (PK) and it also occurs at much lower rate after normal-risk Descemet Membrane Endothelial Keratoplasty (DMEK). After PK, endothelial rejection lines (Khodadoust lines) often originate from corneal neovascularizations. In contrast to PK, Khodadoust lines are rare in rejections after DMEK. These patients might still have very good vision despite increasing amounts of keratic precipitates over weeks or months and the diagnosis of rejection is frequently made by chance during routine examinations. Little is known about the factors that cause the lower rate of immune responses after DMEK. Differences between the two transplantation techniques that may have an impact on the development of rejection include suture-induced angiogenesis, the extent of disruption of the blood-aqueous barrier caused by the surgery, the distance of transplanted tissue from the recipient's vascular bed, and the transplantation of donor antigen-presenting cells.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.