Corneal grafts in the second eye

A series of 51 patients with bilateral penetrating corneal grafts was followed for 1-12 years to assess the effect of the second eye corneal graft on the incidence of allograft rejection. In 33 patients (66 eyes) who had avascular grafts, there was no significant increase in the incidence of allograft rejection reaction after corneal transplantation in the second eye. In 18 patients (36 eyes) who had vascularized corneas, there was a twofold increase in the incidence of allograft rejection in the second as well as in the first corneal graft. Based on this observation and other reports cited in the literature, we offer contraindications for grafting of the second eye.