Evaluation of graft–host interface after penetrating keratoplasty using anterior segment optical coherence tomography

To evaluate the characteristics of the graft–host interface after penetrating keratoplasty (PKP) using anterior segment optical coherence tomography (AS-OCT).

Forty-nine eyes of 49 patients with three different underlying diseases (corneal scar, 22 eyes; bullous keratopathy, 14 eyes; keratoconus, 13 eyes) who underwent PKP were retrospectively reviewed. AS-OCT was performed in all patients and wound profiles of the graft–host junctions were classified into well-apposed junction, gap, step, and protrusion. The correlations between clinical characteristics and wound profiles from the AS-OCT were analyzed.

A total of 392 graft–host junctions from 49 eyes were analyzed. Among them, 155 sections (39.5 %) had well-apposed junctions and 237 sections (60.5 %) had malapposed junctions. The most frequent type of malapposition was protrusion (117 sections, 39.9 %). When categorizing the eyes according to the most frequent alignment type among the 8 cross-sections, the alignment pattern showed significant differences between the preoperative diagnosis groups (P = 0.04). Spherical equivalent (P = 0.04) and keratometric astigmatism (P < 0.01) showed significant differences between the alignment groups. Graft–host thickness disparities showed significant correlations with keratometric astigmatism (r = 0.56, P < 0.01) and degree of graft oversize (r = 0.29, P = 0.04).

The alignment pattern of wound interface after PKP differed according to the clinical diagnosis before surgery and was significantly associated with spherical equivalent and keratometric astigmatism.