[An immunohistological study on a failed case of keratoepithelioplasty form alkali burn on the ocular surface]

We performed immunohistochemical study on a failed case of keratoepithelioplasty (KEP). A 33-year-old man underwent KEP with lammellar keratoplasty (LKP) for an alkali burn suffered 5 years previously. After several rejections, the cornea developed opacity. We performed surgery a second time with the same method, and investigated the removed keratoconjunctival tissue including the lenticule using enzyme labelled antibodies UCHL-1, MB-1, CD4, CD8, CD54 (ICAM-1), CD68, and HLA-DR. Conjunctival tissue extended to the lamellar corneal graft over the lenticule. Either UCHL-1, CD4, or CD8 positive lymphocytes infiltrated the subconjunctival tissue dominantly, but they were blocked by the lenticule or Bowman's membrane of the graft cornea. In the stroma of the lamellar graft cornea, CD4 or CD8 positive, ICAM-1 or HLA-DR expression cells were detected. It was concluded that the lenticule and Bowman's membrane of the lamellar graft block infiltration of the immune cells.