Corneal transplant for therapy of primary corneal dystrophies

Penetrating corneal transplants for primary corneal dystrophies such such as keratoconus and Fuchs dystrophy, and for hereditary dystrophies such as granular, lattice, and macular have an excellent prognosis of 95% or more for a clear graft and good vision in the series presented. These dystrophies are rarely associated with corneal vascularization, unless induced by silk sutures, knots of sutures, exudate, or repeated operations. Accordingly, the incidence of homograft rejection is reduced. However, there is a slower rate of healing, especially with nylon sutures which should not be removed for at least six months. The use of steroids, especially with intensive administration topically or over a long period of time, subconjunctival injection of repository forms, or theoretically at least, systemic administration, can be followed by posterior subcapsular lens opacities which may remain stationary if medication is stopped. Unfortunately, within several years the hereditary dystrophies may slowly develop a recurrence of the dystrophy in the graft requiring reoperation.