Local Immunosuppression in Corneal Transplantation

  • Ali R. Djalilian
  • Edward J. Holland
Part of the Medical Intelligence Unit book series (MIU.LANDES)

Abstract

Corneal transplantation (penetrating keratoplasty) is currently the most common and successful type of tissue transplant performed in the U.S. The remarkable survival of corneal allografts can be largely attributed to their unique avascular structure. This feature allows the graft to remain hidden from the host’s immune system, and effectively renders it immunologically-privileged status. Nonetheless, immune-mediated rejection remains the leading cause of graft failure.1 Up to 30% of penetrating keratoplasty patients will have at least one episode of rejection.2 These usually occur between 4 and 18 months postoperatively, but may occur up to years after successful transplantation. The incidence of rejection is further increased in corneal grafts that develop neovascularization (e.g., due to previous rejection).1,2 In these vascular corneas, the recipient’s immune system can recognize and attack the donor tissue much more readily, thus leading to a higher failure rate. Other factors that can increase the risk of immune-mediated rejection include repeat grafts, bilateral grafts, history of inflammatory eye disease and presence of adhesions.2

Keywords

Corticosteroid Glaucoma Prednisolone Cataract Encapsulation 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • Ali R. Djalilian
  • Edward J. Holland

There are no affiliations available

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