Histopathological Study of Delayed Regraft After Corneal Graft Failure

PURPOSE: To evaluate the histopathological features of corneal graft failures over time. METHODS: A single-center retrospective analysis was performed on corneal specimens diagnosed as corneal graft failure retrieved from The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry (Montreal, Canada) over a 9-year period. The corneal buttons were divided into 3 different groups according to the time between the diagnosis of corneal graft failure and regraft. Corneal specimens obtained during keratoplasty were subjected to hematoxylin and eosin and periodic acid-Schiff. Five different histopathological findings were evaluated in each specimen. RESULTS: Overall, the most common histopathological finding was endothelial decompensation (97.2%). Subepithelial pannus (38.9%), vessels in the corneal stroma (11.1%), and anterior synechiae (2.8%) were the other present findings. The inflammatory reaction was considered discrete in 83.3% of the cases. The only significant histopathological finding correlated with time was the presence of vessels in the corneal stroma (P = 0.0092). CONCLUSIONS: Corneal neovascularization, represented by the presence of vessels in the corneal stroma, was the only histopathological finding correlated with time. Because it is a known factor of poor prognosis, our findings strongly support that early regraft has higher chances of success.