PROBLEMS OF PENETRATING CORNEAL GRAFTING LATE RESULTS IN 18 CASES

It is well-known that the outcome of corneal grafting depends largely on the disease responsible for the corneal opacities. In this connection it may be mentioned that clear grafts were obtained in between 80-900/0 of cases with keratoconus and Groenouws keratitis, in 60 O/O of interstitial luetic keratitis and in nearly 30 O/O of cases in the explosion injuries, traumatic lesions and chemical burns group (37). Possible improvements in operation results must be based upon the study of the causes responsible for the complications that arise. In this respect a clinical material, though too small for statistical evaluation of the results, may nevertheless be of value. Experience gained from the 18 cases reported in this paper provides grounds for debating the question of how long graft fixation should be maintained so that adaptation to the recipient cornea will not be disturbed during the first post-operative stage. The hospital stay of the patients usually lasted from 6 to 8 weeks, thereby making it possible to carry out careful control of the complications which so often arise during the critical post-operative period. Control of the effects of cortisone on oedema and vascular invasion of the graft and recipient cornea was of particular interest. Although the patients in this series did not undergo either preor post-operative radiation treatment, a short discussion of the therapy will be included in this paper. The best possible results from keratoplasty can only be obtained by using donor cornea of superior quality. Great dissention prevails, however, as to whether cornea excised shortly after the donor's death or used after a period of cold storage represents the best donor material. The author does not feel