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Article
August 1996

Primary Corneal Graft Failure

Author Affiliations

Erlangen, Germany

Arch Ophthalmol. 1996;114(8):1031. doi:10.1001/archopht.1996.01100140239040

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Abstract

We are surprised that in the important study by Wilhelmus et al,1 the corneal involvement in pseudoexfoliation syndrome is not mentioned. In view of the reduced endothelial count,2,3 the evidence of direct involvement of the individual corneal endothelial cells by local production of this peculiar extracellular matrix material,4,5 and the observation of corneal endothelial decompensation in the sense of "pseudoexfoliation keratopathy,"6 this would be of interest in the discussion of primary corneal graft failure. In addition, there is a possibility that pseudoexfoliation syndrome might be transferred through corneal transplantation to relatively young patients with keratoconus.7 In view of these clinical and laboratory findings, we believe that the health of the donor eye has a substantial impact on the potential success of a graft, and that intraocular and systemic conditions such as pseudoexfoliation syndrome should be specifically looked for in all eyes yielding donor corneas.

References
1.
Wilhelmus KR, Stulting RD, Sugar J, Khan MM.  Primary corneal graft failure: a national reporting system . Arch Ophthalmol . 1995;113:1497-1502.Article
2.
Miyake K, Matsuda M, Inaba M.  Corneal endothelial changes in pseudoexfoliation syndrome . Am J Ophthalmol . 1989;108:49-52.
3.
Knorr HLJ, Jünemann A, Händel A, Naumann GOH.  Morphometrische und qualitative Veränderungen des Hornhautendothels bei Pseudoexfoliationssyndrom . Fortschr Ophthalmol . 1991;88:786-789.
4.
Schlötzer-Schrehardt U, Dörfler S, Naumann GOH.  Corneal endothelial involvement in pseudoexfoliation syndrome . Arch Ophthalmol . 1993;111:666-674.Article
5.
Naumann GOH, Schlötzer-Schrehardt U.  Corneal endothelial involvement in pseudoexfoliation syndrome . Arch Ophthalmol . 1994;112:297-298.Article
6.
Naumann GOH.  Corneal transplantation in anterior segment diseases: The Bowman Lecture 1994, part II . Eye . 1995;9:395-421.Article
7.
Küchle M, Naumann GOH.  Occurrence of pseudoexfoliation following penetrating keratoplasty for keratoconus . Br J Ophthalmol . 1992;76:98-100.Article
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