Occurrence of pseudoexfoliation following penetrating keratoplasty for keratoconus

The occurrence of pseudoexfoliation (PSX) following penetrating keratoplasty for keratoconus is reported in three eyes of two patients. The patients' ages at keratoplasty were 37, 40, and 31 years, and PSX was first observed 5, 4, and 6 years following keratoplasty. The donor age was 76, 81, and 81 years. Possible explanations for the occurrence of PSX after keratoplasty include mere coincidence, some sort of non-specific reaction to surgery or to postoperative medication, an immunogenic reaction to transplanted foreign corneal tissue, and the hypothetical speculation that PSX might be a transmissible disease.