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[Corneal transplantation].

K B Mellin1

  • 1Augenklinik, Universitätsklinikums der Gesamthochschule, Essen.

Zentralblatt Fur Chirurgie
|January 1, 1992
PubMed
Summary

Corneal transplantation involves tissue grafts with fewer immune cells than organ transplants. Lamellar grafts reduce rejection risk compared to penetrating grafts, and Ciclosporin A helps maintain graft clarity.

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Area of Science:

  • Ophthalmology
  • Immunology
  • Transplantation Science

Background:

  • Corneal grafts are tissue transplants with a lower immune cell load than organ transplants.
  • Penetrating keratoplasty faces higher allograft rejection rates than lamellar keratoplasty due to endothelial immune responses.
  • Endothelial cell damage leads to graft decompensation.

Purpose of the Study:

  • To compare rejection rates between penetrating and lamellar corneal grafts.
  • To investigate the role of human leukocyte antigen (HLA) matching in corneal transplantation.
  • To evaluate the efficacy of Ciclosporin A in maintaining corneal graft survival.

Main Methods:

  • Comparative analysis of graft rejection incidence based on graft type (penetrating vs. lamellar).
  • Assessment of human leukocyte antigen (HLA)-A, -B, and -DR matching in specific corneal transplantation scenarios.
  • Evaluation of immunosuppressive therapy using Ciclosporin A for graft maintenance.

Main Results:

  • Lamellar grafts exhibit lower rejection rates than penetrating grafts, attributed to reduced endothelial immune reactions.
  • HLA matching demonstrates significance in vascularized corneas or repeat penetrating keratoplasty.
  • Ciclosporin A treatment proved effective in preserving corneal graft clarity.

Conclusions:

  • Lamellar keratoplasty is advantageous over penetrating keratoplasty in minimizing immune rejection.
  • HLA matching and targeted immunosuppression are crucial for successful corneal allografts, particularly in high-risk cases.
  • Ciclosporin A is a valuable therapeutic agent for ensuring long-term corneal graft survival.

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