Pathological Evaluation of Corneal Regrafts During Ten Years at a Tertiary Referral Center in Tehran, Iran

Purpose: To evaluate the histopathological and epidemiologic features of corneal regrafts over ten years. Methods A single-center retrospective analysis was performed on corneal specimens diagnosed as corneal graft failure retrieved from The Farabi Eye Hospital (Tehran, Iran) over a 10-year period. Also, Demographic data including sex, age, laterality, primary diagnosis, type of graft, cause of corneal regraft, associated eye diseases and systemic comorbidities were evaluated. Results Among a total of 3120 corneal grafts, 267 of them (8.55%) were regrafts. Main cause of graft failure was corneal ulcer. The most common type of grafting was penetrating keratoplasty (PK), but most common type of regrafting surgery was DSAEK. The Main causes of graft failure was Infectious keratitis. The most common histopathological finding was Bowman layer disruption (81%) and stromal scar (80%). Stromal edema, retro corneal fibrous, sub epidermal bulla and stromal vascularization were the other present findings. The inflammatory reaction was considered discrete in 59.45% of the cases and dominant cell type was polymorphonuclear neutrophils (PMNs). Conclusion Infectious keratitis was the major cause of failure in our study. Considerable presence of histopathological changes such as retro corneal fibrous, sub epidermal bulla needs further investigations. Perhaps, proper education of infectious keratitis risk factors, as well as regular examinations and proper antibiotic prophylaxis can reduce the rate of the corneal graft failure