Corneal allograft rejection is a major complication of penetrating keratoplasty (PK). We used the laser flare-cell meter that allows, for the first time, noninvasive quantification of aqueous flare in vivo to analyze alterations of the blood-aqueous barrier following uncomplicated PK and in acute corneal graft rejection.
Patients and Methods:
Examination with the laser flarecell meter was performed in 67 eyes of 62 patients (mean±SD age, 46.2±15.1 years) 12.8±13.2 months (range, 5 days to 60 months) after uncomplicated PK, in 82 normal control eyes of 82 age- and gender-matched patients (mean age, 49.0±17.1 years) and in 10 eyes of 10 patients (mean age, 51.6±15.1 years) with acute diffuse endothelial corneal graft rejection in nonherpetic eyes 15.1±12.9 months after PK.
Compared with the normal unoperated control group (4.43±1.13 photon counts/ms), aqueous flare was significantly increased during the first 2 weeks following uncomplicated PK (14.73±8.30 photon counts/ms; P<.0001) but returned to normal levels more than 6 weeks after surgery (4.48±1.55 photon counts/ms; P>. 1). In acute corneal graft rejection, aqueous flare values (17.10±6.05 photon counts/ms) increased to significantly higher levels than in eyes following uncomplicated PK and in the normal control group (P<.0001), but decreased significantly 9.5±3.3 days after treatment with systemic and topical corticosteroids (5.78±2.16; P<.0005).
Application of the laser flare-cell meter appears promising for following up patients after PK and for detecting early corneal allograft rejection.
Küchle M, Nguyen NX, Naumann GOH. Aqueous Flare Following Penetrating Keratoplasty and in Corneal Graft Rejection. Arch Ophthalmol. 1994;112(3):354-358. doi:10.1001/archopht.1994.01090150084028