We compared the incidence of graft rejection and the rejection time after penetrating keratoplasty on the 72 keratoconus patients retrospectively between the range of 5.5 mm to 7.0 mm diameter in graft size(Group 1) and the range of 7.25 mm to 8.0 mm diameter(Group 2). The graft rejection was developed in 25 eyes(28.09%) among 89 penetrating keratoplasty patients with keratoconus. In group 1, there was graft rejection in 6 eyes(23.08%) among 26 eyes and in group 2, 19 eyes(30.16%) among 63 eyes. The rejection time of 21 eyes(84.00%) was within the first postoperative year. In group 1, graft rejections in 5 eyes(83.33%) were noted within the first postoperative year among 6 rejected eyes, and in group 2, rejections in 16 eyes(84.21%) among 19 rejected eyes. The statistical analysis showed no significant differences between the two groups in the incidence of graft rejection and rejection time(p>0.05).
Corneal Transplantation* ; Graft Rejection* ; Humans ; Incidence ; Keratoconus* ; Keratoplasty, Penetrating ; Retrospective Studies ; Transplants*

In order to evaluate the clinical application of the Nd:YAG laser(Coherent model 9900(R)) to correct the astigmatism, we observed the change in corneal curvature, thickness and endothelium after laser radiation to the rabbit cornea. The experiment composed of 14 rabbit eyes divided into two groups according to the power setting; 7 eyes of 2.5mJ group, and 7 eyes of 5mJ group. Lader pulse was focused at corneal epithelium and an average of 25-30 applications were required to make the single pair of transverse line like conventional lineal corneal transverse incision for one eye. Changes ir keratometry and pachymetry were measured postlaser application for 3 months. Seven days after radiation, two rabbit eyes(2.5mJ and 5mJ) were enucleated for scanning electron microscopy. The results were as follows: 1. The mean flattening induced at 900 meridian was 1.91 diopter in 2.5mJ group and 1.98 diopter in 5mJ group 3 months after laser radiation, and the difference between the two groups was not statistically significant(p>0.5). 2. The steepening at 1800 meridian induced only one week after laser radiation in both groups, thereafter the flattening was shown. 3. The significant mean corneal thickness increase of 30.72pm in 2.5mJ group and 33.47 micrometer in 5mJ group was noted at postlaser 7 days and returned to normal range at postlaser 2 months, but the corneal thickness showed no significant statistical difference between two group(p>0.5). 4. Scanning electron microscopy findings showed changes of the ultrastructure of the endothelial cell: edematous changes of the endothelial cell and cell membrane destruction were much less in 2.5mJ group than 5mJ group.
Astigmatism ; Cell Membrane ; Cornea ; Endothelial Cells ; Endothelium* ; Epithelium, Corneal ; Microscopy, Electron, Scanning ; Rabbits* ; Reference Values

In order to evaluate the clinical application of the Nd:YAG laser(Coherent model 9900(R)) to correct the astigmatism, we observed the change in corneal curvature, thickness and endothelium after laser radiation to the rabbit cornea. The experiment composed of 14 rabbit eyes divided into two groups according to the power setting; 7 eyes of 2.5mJ group, and 7 eyes of 5mJ group. Lader pulse was focused at corneal epithelium and an average of 25-30 applications were required to make the single pair of transverse line like conventional lineal corneal transverse incision for one eye. Changes ir keratometry and pachymetry were measured postlaser application for 3 months. Seven days after radiation, two rabbit eyes(2.5mJ and 5mJ) were enucleated for scanning electron microscopy. The results were as follows: 1. The mean flattening induced at 900 meridian was 1.91 diopter in 2.5mJ group and 1.98 diopter in 5mJ group 3 months after laser radiation, and the difference between the two groups was not statistically significant(p>0.5). 2. The steepening at 1800 meridian induced only one week after laser radiation in both groups, thereafter the flattening was shown. 3. The significant mean corneal thickness increase of 30.72pm in 2.5mJ group and 33.47 micrometer in 5mJ group was noted at postlaser 7 days and returned to normal range at postlaser 2 months, but the corneal thickness showed no significant statistical difference between two group(p>0.5). 4. Scanning electron microscopy findings showed changes of the ultrastructure of the endothelial cell: edematous changes of the endothelial cell and cell membrane destruction were much less in 2.5mJ group than 5mJ group.
Astigmatism ; Cell Membrane ; Cornea ; Endothelial Cells ; Endothelium* ; Epithelium, Corneal ; Microscopy, Electron, Scanning ; Rabbits* ; Reference Values

We performed keratoplasty and did not remove suture material in 189 patients (189 eyes) after operation. Among them, 48 eyes which had clear grafts with spontaneous suture breakage had been analyzed retrospectively for the age, the sex distribution, the time and the site of broken suture, the preoperative diagnosis and the relationship between the suture breakage and the presence of vasculized recipient bed or suture method. The time when suture was broken after keratoplasty ranged from 3 months to 80 months(average 30 months). Leukoma cornea, 25 eyes(52.1%) and keratoconus, 13 eyes(27.1%) were the most common cause of keratoplasty and the others were corneal dystrophy, Fuchs dystrophy and re-keratoplasty. The most common site of broken suture was at superior quadrant(30 eyes, 62.5%), The vasculized recipient bed was found in 16 eyes, 13 eyes of leukoma cornea and 3 eyes of fe-keratoplasty in preoperative state. The statistical analysis showed significant relationship between the presence of vasculized recipient bed and the suture breakage(p<0.05). Suture was broken in 28 eyes(26.7%) of 105 eyes with single continuous suture, 6 eyes(21.9%) of 20 eyes with combined interupted suture and 14 eyes(21.9%) of 64 eyes with combined interupted and continuous suture. The statistical analysis showed no significant relationship between the suture method and the suture breakage(p>0.05).
Cornea ; Corneal Opacity ; Corneal Transplantation* ; Diagnosis ; Fuchs' Endothelial Dystrophy ; Humans ; Keratoconus ; Retrospective Studies ; Sex Distribution ; Sutures* ; Transplants

Posterior polymorphous dystrophy is a bilateral, dominantly inherited (rarely recessively inherited) disorder of corneal endothelium, characterized by a spectrum of changes in posterior cornea and less commonly in the iris and angle structures. We have experienced a 39-year-old male patient complaining of visual disturbance in the right eye. On examination, we found characteristics of postenor polymorphous dystrophy which were Descemet's membrane thickening. peripheral anterior synechiae, iridocorneal adhesion. abnormal corneal endothelial cells in both eyes, and corneal epithelial and stromal edema in the right eye and after penetrating keratoplasty, the result was good. Therefore, we report a case of posterior polymorphous dystrophy with review of literatures.
Adult ; Cornea ; Descemet Membrane ; Edema ; Endothelial Cells ; Endothelium, Corneal ; Humans ; Iris ; Keratoplasty, Penetrating ; Male

Schnyder's crystalline corneal dystrophy is a hereditary disease of unknown etiology, and characterized by bilateral subepithelial corneal opacification with crystalline or diffuse deposits of cholesterol or other lipid. It is rare and has never been reported in Korea. The authors experienced a case of Schnyder's crystallin corneal dystrophy examined in a 36-year-old man who had bilateral corneal crystalline deposits since 15 years old and significant reduction in vision for two years. Light microscopic examination of patient's keratoplasty specimen showed lipid deposits in the superficial stroma, and electron microscopy disclosed multiple lipid vacuoles in basal epithelium, Bowman slayer, superficial stroma and keratocytes. In this report, we describe the histopathological findings of Schnyder's crystalline corneal dystrophy.
Adolescent ; Adult ; Cholesterol ; Corneal Opacity ; Corneal Transplantation ; Crystallins* ; Epithelium ; Genetic Diseases, Inborn ; Humans ; Korea ; Microscopy, Electron ; Vacuoles

We analyzed the result of the tests about HBs Ag, HCv Ag, HIV Ag and VDRL in the blood of the donor and evaluated sex and age distribution, cause of death of the donor, which were obtained from Central Eye Bank at St. Mary's Hospital from January 1, 1993 to December 31, 1994. 1. Hepatitis B surface Ag in the blood was positive in 13 donors(4.80%) and Hepatitis C Ag was in 4 donors(1.48%). 2. VDRL test in the blood was positive in 11 donors(4.06%) and HIV Ag was in 1 donor(0.37%). 3. In sex and age distribution, 128 donors(47.23%) were male and 3 donors(52.77%) were from 71 to 80 years was the major group of donors(67 donors: 24.72%). 4. The most common cause of death was respiratory disease(94 donors: 34.69%) and then tumor(76 donors: 28.04%), circulatory disease(66 donors: 24.35%), metabolic disease (19 donors: 7.01%), infection(9 donors: 3.32%) and trauma(7 donors: 2.58%).
Age Distribution ; Cause of Death ; Eye Banks ; Hepatitis B ; Hepatitis C ; HIV ; Humans ; Male ; Metabolic Diseases ; Tissue Donors*

The maintenance of corneal endothelial cells is essential for success of corneal transplantation. Endothelial cell count by specular microscope and measurement of donor corneal thickness is useful in measuring the function of cornea. We studied difference of corneal thickness in central and peripheral corneal region in enucleated eye. We measured corneal thickness of 48 eyes(48 persons) with ultrasound pachymetry that were presented to The Eye Bank of Catholic University Medical College. Average age was 61.42+/-16.12 years and average time was 163.02+/-102.52 minutes until measurement of corneal thickness after death. Increased amount of corneal thickness was 136.73+/-101.44micrometer in center and 61.37+/135.46micrometer in periphery compared with normal average corneal thickness. According to these results, corneal edema due to functional loss of endothelial cells after death lead to increased corneal thickness, especially in central region being more statistically significant than peripheral region (p=0.002).
Cornea ; Corneal Edema ; Corneal Transplantation ; Endothelial Cells ; Eye Banks ; Humans ; Tissue Donors ; Ultrasonography

Endophthalmitis is an intraocular inflammation caused by bacteria or fungus. Although endophthalmitis may result from an endogenous source elsewhere in the body, it most commonly occurs following intraocular surgery or penetrating ocular injury. But endophthalmitis following penetrating keratoplasty reveals the significantly lower incidence than by other causes. We have experienced one case of bacterial endophthalmitis following penetrating keratoplasty which was proved to be Pseudomonas aeruginosa by bacterial culture. In spite of two intravitreal injection of proper antibiotics, his clinical symptoms and signs did not improve and his visual acuity decreased to hand movement. So, we performed pars plana vitrectomy and third intravitreal injection of antibiotic and achieved a successful results with final visual acuity of 6/20. We report a case of endophthalmitis following penetrating keratoplasty and with the review of literature.
Anti-Bacterial Agents ; Bacteria ; Endophthalmitis* ; Fungi ; Hand ; Incidence ; Inflammation ; Intravitreal Injections ; Keratoplasty, Penetrating* ; Pseudomonas aeruginosa ; Visual Acuity ; Vitrectomy

We conducted a retrospective study of 30 penetrating keratoplasties (30 patients) for corneal opacity due to herpes simplex keratitis from Jan. 1980 to Dec. 1989 at St. Mary's Hospital. The follow-up periods ranged from 1.3 years to 11 years (mean; 4.8 years). Overall, 23 out of the 30 transplants (76.7%) remained clear grafted cornea and 18 eyes (60%) achieved good to excellent visual acuities (0.3 or better). Herpes simplex keratitis was inactive at the time of corneal transplantation in 27 eyes (90%) and the recurrent rate after surgery was 18.5%. Patients with active ulceration or perforation, had particularly poor success rates. The overall rate of recurrent herpetic keratitis after transplantation for herpes was 26.6% Preoperative corneal neovascularization was not a statistically significant prognostic factor with regard to final visual outcome, graft clarity, graft rejection or recurrent herpetic keratitis.
Cornea ; Corneal Neovascularization ; Corneal Opacity ; Corneal Transplantation* ; Follow-Up Studies ; Graft Rejection ; Herpes Simplex* ; Humans ; Keratitis, Herpetic* ; Keratoplasty, Penetrating ; Recurrence* ; Retrospective Studies ; Transplants ; Ulcer ; Visual Acuity