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December 1978

Subepithelial Infiltrates: A Probable Sign of Corneal Transplant Rejection

Author Affiliations

From the Iowa Lions Cornea Center, Department of Ophthalmology, University of Iowa Hospitals, Iowa City.

Arch Ophthalmol. 1978;96(12):2234-2237. doi:10.1001/archopht.1978.03910060536013

• A previously undescribed slit-lamp manifestation of a probable corneal transplant rejection reaction was found in 22 patients among 145 who underwent penetrating keratoplasty during a two-year period. The reaction consisted of subepithelial infiltrates that were located only in the donor tissue; were without associated conjunctivitis; and that occurred six weeks to 21 months postoperatively, either alone or in association with epithelial and/or endothelial rejection; and that responded well to topical corticosteroid treatment. In one case, the subepithelial infiltrates preceded a severe endothelial rejection by only a few days. The lesions are a warning that all is not well and that corticosteroid therapy should be instituted or increased.

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