Epithelial downgrowth following penetrating keratoplasty in the aphake

Four of approximately 1,500 patients receiving corneal grafts developed epithelial downgrowth following penetrating keratoplasty. All were aphakic prior to grafting and had complicated postoperative courses. Epithelial proliferation over the iris and endothelium was demonstrated in three cases at the time of a repeat keratoplasty. While rare, this complication may occur more frequently than has been previously recognized.