Clinical features of immune rejection after corneoscleral transplantation.
OBJECTIVE
To summarize the clinical features of immune rejection after corneoscleral transplantation.


METHODS
A retrospective, noncomparative, observational case series.


METHODS
Patients who received corneoscleral transplantation because of whole corneal ulcer or corneal perforation at Shandong Eye Institute from July 1, 2003 through July 31, 2005 were included. Fourteen patients (14 eyes) with immune rejection but not recurrence or other complications were reviewed, including ocular vision, rejection onset time, symptoms, and characteristics.


RESULTS
The average rejection time in the 14 eyes was 35 days. The rejection arose rapidly, and the mean best-corrected visual acuity decreased to counting fingers or hand movements. Circular limbal congestion and edema developed with circuitous and dilatational vessels. Whole graft edema and Descemet membrane folds were present, but no epithelial rejection line, endothelial rejection line, or keratic precipitate were observed. The average intraocular pressure (IOP) dropped from 13.6 mm Hg to 7.4 mm Hg. Seven eyes had shallow anterior chambers (AC). Retinal and choroidal edema was observed in five eyes.


CONCLUSIONS
The clinical features of immune rejection after corneoscleral transplantation include rapid onset of rejection, vision decrease, circular limbal congestion and edema with circuitous and dilatational vessels, whole graft edema and shallow AC, low IOP, and no rejection line or keratic precipitate.
Shi
Weiyun
W
State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Qingdao, China. weiyunshi@163.com
Wang
Ting
T
Zhang
Ju
J
Zhao
Jing
J
Xie
Lixin
L
D000468:Alkalies; D000867:Anterior Chamber / Q000473:pathology; D002057:Burns, Chemical / Q000601:surgery; D015715:Corneal Edema / Q000209:etiology / Q000473:pathology; D016039:Corneal Transplantation / Q000276:immunology*; D003320:Corneal Ulcer / Q000601:surgery*; D003886:Descemet Membrane / Q000473:pathology; D005126:Eye Burns / Q000139:chemically induced / Q000601:surgery; D005260:Female; D006084:Graft Rejection / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D007634:Keratitis / Q000382:microbiology / Q000601:surgery; D008297:Male; D009181:Mycoses; D012008:Recurrence; D012189:Retrospective Studies; D012590:Sclera / Q000637:transplantation*; D013997:Time Factors; D014463:Ultrasonography; D014785:Vision, Ocular; D014792:Visual Acuity
D000468:Alkalies