Good early results seen with pre-Descemet’s endothelial keratoplasty in failed grafts

Graft failure in any situation can happen due to inherent defects in the donor graft or pre-existing pathology in the recipient. Inherent graft issues such as low endothelial cell count, surgical trauma to the graft and endothelial disease in the donor can cause early graft failure. Graft rejection is another main etiology that can happen, especially in full-thickness keratoplasty. Lamellar keratoplasty procedures have been shown to have fewer incidences of rejection, but rejection has been noticed after deep lamellar keratoplasty. The corneal stroma is the culprit often recognized as the cause of rejection because of its antigenic nature.A failed penetrating graft can be replaced by another penetrating full-thickness graft or by an endothelial graft. In this article, we will discuss our experience of pre-Descemet’s endothelial keratoplasty in previous failed grafts.