Corneal Transplants (F)

Question 1

Which immunosuppressants are typically used for a corneal transplant?

Answer 1

none

Question 2

What is the percentage of rejections if the MHC is a complete mismatch? 1. If only MHC I? 2. If only MHC II? 3

Answer 2

1. 50%
2. 20%
3. less than 10%

Question 3

Do keratoconic patients tend to have more or less corneal graft rejections?

Answer 3

less

Question 4

What is the corneal transplant that replaces all 5 corneal layers?

Answer 4

Penetrating keratoplasty (PK)

Question 5

What is the corneal transplant that replaces that epi and stroma?

Answer 5

anterior lamellar keratoplasty (ALK)

Question 6

What is the corneal transplant that replaces the Descemet’s and endothelium?

Answer 6

endothelial keratoplasty (EK)

Question 7

What percentage of donor endothelial cells are lost during a transplant?

Answer 7

30 to 40%

Question 8

When is the onset of epithelial graft rejection? 1. What is the treatment? 2

Answer 8

1. about 3months

2. usually self limiting

Question 9

What are the signs of epithelial graft rejection?

Answer 9

1. linear pattern from graft periphery
2. elevated, undulating line of tissue
3. infiltrates can develop (Kaye’s dots)

Question 10

What are the signs of chronic stromal graft rejection?

Answer 10

infiltrates on donor tissue only but usually no failure

Question 11

What are the signs of acute stromal graft rejection?

Answer 11

1. usually with endothelial rejection
2. vessel congestion
3. stromal haze

Question 12

What is the most symptomatic and devastating graft rejection type?

Answer 12

focal (endothelial)

Question 13

What are the signs of focal graft rejection?

Answer 13

1. AC reaction with KPs (scattered or chain-like)

2. graft edema (folds in Descemets)

Question 14

What is the main reason for graft rejection in DALK patients?

Answer 14

haze at interface