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COMMISSIONED ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 3  |  Page : 163-170

High-risk penetrating keratoplasty


Department of Cornea and Ocular Surface, PBMA's H V Desai Eye Hospital, Pune, Maharashtra, India

Correspondence Address:
Shilpa Ajit Joshi
Department of Cornea and Ocular Surface, PBMA's H V Desai Eye Hospital, Hadapsar, Pune - 411 060, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2320-3897.190792

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Background: Loss of immune privilege has important connotations for graft survival, often in clinical scenarios where the other eye is irreversibly blind. This article looks at the state of the evidence-based treatment available for high-risk penetrating keratoplasty (P.K.). Materials and Methods: Review of pathophysiological and immunological mechanisms present was done. Conclusion: Pre-, intra-, and post-operative considerations in P.K. in high-risk situation along with the role of immune-suppression are discussed. Success in high-risk keratoplasty depends on an ongoing effort during as well as life-long after P.K. The role of nonimmunological factors such as glaucoma, reactivation of infection, and unstable ocular surface are important determinants in graft failure.


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