The histopathology of a case of keratophakia

We studied a human cornea that was obtained at the time of penetrating keratoplasty four months after a keratophakia procedure and cataract extraction. We found endothelial cell loss with corneal edema, interface epithelial ingrowth, absence of keratocytes, and an abnormality in the collagen structure of the donor homograft (lenticule) and abnormal host keratocytes in the recipient lamellar (host) bed. We suspect that the cause of keratocyte and collagen injury was associated with the cryopreservation process. We recommend that if a combined cataract extraction and keratophakia procedure is contemplated, the lens extraction be performed in an intracapsular fashion if the keratophakia procedure has been completed or in an extracapsular fashion before the replacement of the donor lenticule and anterior part of the host cornea.