Histologic findings in a series of 1,540 corneal allografts

We present a series of 1,540 corneal allografts studied since 1982. Corneal edema was the major lesion in 439 corneal specimens (28.4%). Keratitis was the largest group with 378 cases (24.5%), including 134 cases of corneal scarring (8.7%). There were 113 cases of herpes simplex virus keratitis (7.3%), mostly of the disciform stromal type, and 60 cases of non herpetic interstitial keratitis (3.9%), 44 of superficial keratitis (2.8%) and 10 of ulcerative keratitis (0.6%). Among the 17 other cases (1.1%), there were 3 of fungal keratitis, 2 syphilitic keratitis and one case of acanthamoebic keratitis. The third group was formed by corneal dystrophies with 376 cases (24.4%). There were 192 keratoconus (12.5%), 121 Fuchs' dystrophies (7.9%), 28 calcific band keratopathies (1.8%), 18 had corneal dystrophies with amyloid deposits and 16 did not. There were 169 regrafts (11%) and 135 traumatic lesions (8,8%). Among the 43 miscellaneous cases (2,8%), there were 22 cases with previous refractive eye surgery, one corneal myxoma, 5 cases of dysplasia, 5 pterigia, 3 sclerocornea, one fish-eye disease, one floppy eyelid syndrome and 5 unclassifiable cases. The mechanisms of these lesions are mainly related to an autoimmune disease in most cases of herpes keratitis. Some rare forms of corneal dystrophies contain amyloid deposits produced by an abnormal kerato-epithelin. Cases of graft failure are not particulary frequent, due to the avascularity of the cornea and its particular immune status.