title: Histology of posterior lamellar keratoplasty.
abstract: OBJECTIVE
  To report histology of a posterior lamellar graft performed to treat clinically significant endothelial disease in a patient with Fuchs dystrophy.
  
  
  METHODS
  A 78-year-old patient with Fuchs dystrophy underwent posterior lamellar keratoplasty (PLK), the original form of endothelial keratoplasty performed with manual lamellar dissection of the recipient and donor corneas. Eighteen months later, the patient had herpes simplex virus keratitis and graft rejection episodes. One year after the infection resolved (2.5 years after PLK), penetrating keratoplasty was performed, and the excised corneal button was examined.
  
  
  RESULTS
  Histopathologic evaluation of the corneal button showed no discernible interface, opacity, or gapping between the anterior host stromal tissue and PLK donor tissue or any signs of significant migration of donor endothelial cells onto recipient tissue.
  
  
  CONCLUSIONS
  This PLK histology showed firm attachment with no visible interface between the posterior donor and anterior host stromal tissue. Surprisingly, no significant donor endothelial cell migration was detected on adjacent recipient tissue where Descemet membrane had been excised or where endothelial cells were lost as a result of the procedure.
authors.affiliation: John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
authors.forename: R Ken
authors.initials: RK
authors.lastname: Lord
authors.forename: Francis W
authors.initials: FW
authors.lastname: Price
authors.forename: Marianne O
authors.initials: MO
authors.lastname: Price
authors.forename: Liliana
authors.initials: L
authors.lastname: Werner
authors.forename: Nick
authors.initials: N
authors.lastname: Mamalis
mesh_terms: D000368:Aged; D016039:Corneal Transplantation; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000473:pathology* / Q000601:surgery; D006084:Graft Rejection / Q000209:etiology / Q000601:surgery; D006801:Humans; D016849:Keratitis, Herpetic / Q000209:etiology / Q000601:surgery; D015948:Keratoplasty, Penetrating; D011183:Postoperative Complications