Modification of the Homograft Reaction in Corneal Transplantation

Abstract

It has long been recognized that the cornea and anterior chamber of the eye are "privileged sites" for graft survival.^1-6This is probably due in large part to relative isolation from the vascular system.^5-7Also, it is conceivable that this environment may be favorable for development of adaptation.⁸It is also true that certain body tissues seem to have inherently less immunological potency.⁹Although homokeratoplasty has been one of the most successful transplantation procedures, there is a significant incidence of graft reactions in routine cases. In extremely scarred, vascularized corneas where there is greater opportunity for interchange between the donor tissue and host immunologic defenses, the prognosis for obtaining a clear graft is guarded.⁷Although recent improvements in surgical technique have improved the outlook in many conditions,^10-12accumulated clinical evidence, including favorable experience with autokeratoplasty in extremely diseased eyes, indicates that the homograft rejection