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.

Histopathologic study of corneal stromal dystrophies: a 10-year experience.

PURPOSE: To determine the frequency and describe the histopathologic features of stromal corneal dystrophies over a 10-year period. METHODS: A single-centered, retrospective analysis was performed on corneal specimens diagnosed as stromal dystrophies retrieved from the Henry C. Witelson Ophthalmic Pathology Laboratory and Registry (Montreal, Canada) over a period of 10 years. Corneal specimens obtained during keratoplasty were subjected to hematoxylin and eosin, periodic acid-Schiff, and other special staining. RESULTS: During the period of the study, 885 corneal specimens from penetrating keratoplasties were received. Twenty-six (2.9%) specimens from a total of 22 patients showed stromal corneal dystrophies: 17 (65.4%) eyes with lattice dystrophy, 5 (19.2%) eyes with combined granular/lattice ("Avellino") dystrophy, 3 (11.5%) eyes with granular dystrophy, and 1 (3.9%) eye with macular dystrophy. CONCLUSIONS: Corneal stromal dystrophies have distinct histopathologic features, which can be diagnosed with routine and special staining, particularly for combined granular/lattice (Avellino) dystrophy. Clinically, combined granular/lattice (Avellino) dystrophy can have features of both lattice and granular dystrophies, which can be misleading for diagnosis. Lattice dystrophy was the most frequent stromal dystrophy in this particular population.