We present a series of 1,540 corneal allografts studied since 1982.
Corneal edema was the major lesion in 439 corneal specimens (28.4%).
Keratitis was the largest group with 378 cases (24.5%), including 134 cases of corneal
scarring (8.7%). There were 113 cases of herpes simplex virus
keratitis (7.3%), mostly of the disciform stromal type, and 60 cases of non herpetic interstitial
keratitis (3.9%), 44 of superficial
keratitis (2.8%) and 10 of
ulcerative keratitis (0.6%). Among the 17 other cases (1.1%), there were 3 of fungal
keratitis, 2 syphilitic
keratitis and one case of acanthamoebic
keratitis. The third group was formed by
corneal dystrophies with 376 cases (24.4%). There were 192
keratoconus (12.5%), 121 Fuchs' dystrophies (7.9%), 28 calcific band keratopathies (1.8%), 18 had
corneal dystrophies with
amyloid deposits and 16 did not. There were 169 regrafts (11%) and 135 traumatic lesions (8,8%). Among the 43 miscellaneous cases (2,8%), there were 22 cases with previous refractive eye surgery, one corneal
myxoma, 5 cases of dysplasia, 5 pterigia, 3 sclerocornea, one
fish-eye disease, one floppy eyelid syndrome and 5 unclassifiable cases. The mechanisms of these lesions are mainly related to an
autoimmune disease in most cases of herpes
keratitis. Some rare forms of
corneal dystrophies contain
amyloid deposits produced by an abnormal
kerato-epithelin. Cases of graft failure are not particulary frequent, due to the avascularity of the cornea and its particular immune status.