Bilateral penetrating autokeratoplasty.

BACKGROUND Corneal transplantation is an important modality for treatment of a variety of degenerative, congenital, and traumatic disorders. Despite great advances in surgical techniques, postoperative care, and eye banking over the past 20 years, corneal graft rejection continues to be a substantial risk to successful outcome. METHODS We describe a series of three cases in which the clear cornea from a blind eye was used to replace an opaque cornea on a fellow eye with known visual potential and the abnormal cornea was transplanted on the blind eye. Mean follow up was 74 months (range, 66 to 84 months). All three patients had concurrent glaucoma at presentation, and one had a highly vascularized cornea. RESULTS Spectacle-corrected vision improved in all cases postoperatively. However, one patient had a non-immune graft failure 58 months after surgery. CONCLUSIONS The use of autologous tissue avoids the risk of allograft rejection after penetrating keratoplasty and eliminates the need for long-term postoperative corticosteroids which may exacerbate pre-existing glaucoma. In selected patients, autokeratoplasty can be a useful technique, especially if heavy corneal vascularization or pre-existing glaucoma is present.