Corneal Graft Rejection: A Review Of Literature And Recent Advances

Immune rejections remain one of the most common causes of failure of penetrating keratoplasty. Epithelial rejection, chronic stromal rejection, hyperacute rejection and endothelial rejection constitute the different types of corneal graft rejection that might occur in isolation or conjunction. Various risk factors have been identified to increase the risk of graft rejections. With a recent advent in lamellar and endothelial keratoplasties, it is important to identify the patterns of rejection in these grafts. Corticosteroids remain the mainstay of prophylaxis and treatment of corneal graft rejection. The role of various immunosuppressive agents, systemic and topical, is being investigated and preliminary reports have shown some benefit. The successful management of corneal graft rejection involves understanding the immunopathogenesis of the same, prevention, early detection and prompt management.