Vortex keratopathy of the corneal graft

We examined the surface epithelium of 30 eyes with color specular microscopy at 3-month intervals 1-18 months following penetrating keratoplasty. At least three examinations were performed on most eyes. We found a vortex keratopathy to be present in 70% of these eyes. In nine eyes, this vortex pattern was present at every examination, and in 12 eyes, it was present at some examinations and not at others. There was no vortex pattern seen at any examination in nine eyes. We also found alterations in the normal epithelial morphology around sutures and at the wound margin, with palisading parallel to the sutures and perpendicular to the wound edge. This altered morphology was also demonstrated by digitization of cells for shape and size, which showed significant differences compared with normals. We conclude that the morphology of the epithelial cells on the surface of the cornea remains abnormal for up to 18 months following penetrating keratoplasty.