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Primary Graft Failure
- Occurs when the donor cornea doesn't retain the transparency sufficient for adequate vision. The most common cause is endothelial cells dysfunction.
- Other causes include sub-optimal condition of donor tissue, intraocular inflammation, hypotony due to ciliary body dysfunction in a traumatized eye, endothelial trauma during surgery, vitreous or iris tissue adherence to endothelium and preexisting glaucoma.
- Symptoms: hazy or blurred vision
- Uncommon complication of penetrating keratoplasty.
- Hazy and graft thickening associated with microcystic edema and multiple stromal or Descemet's folds.
- Intensive instillation of topical steroids around the clock to diminish inflammation.
- Regrafting in cases with persistent corneal edema.
- Donor button should be sent for pathologic evaluation.