Management of keratoplasty in the early stages

Frequent, if not daily, slit-lamp examination of the patient with a penetrating transplant is indicating for more than one reason: it will lead to the early detection of any defect of the host-graft junction or of the graft's posterior surface; it will permit an early diagnosis of the peripheral cornea-iris touch syndrome with all its potential consequences (acute, irreversible mydriasis, iris atrophy, and now and then secondary glaucoma); it will give an exact clue to when to remove the continuous sutures long after these have been covered by epithelium; and it will alert the surgeon in the event of a localised infection. Early and late opacification of the graft will also be correctly appraised, so that the surgeon will know when to wait and when to take the appropriate action.