Chapter 12. The Role of Surgical Factors in Corneal Graft Failure

  1. Ruth Porter and
  2. Julie Knight
  1. Thomas E. Moore and
  2. Samuel B. Aronson

Published Online: 30 MAY 2008

DOI: 10.1002/9780470719985.ch12

Ciba Foundation Symposium 15 - Corneal Graft Failure

Ciba Foundation Symposium 15 - Corneal Graft Failure

How to Cite

Moore, T. E. and Aronson, S. B. (1973) The Role of Surgical Factors in Corneal Graft Failure, in Ciba Foundation Symposium 15 - Corneal Graft Failure (eds R. Porter and J. Knight), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470719985.ch12

Author Information

  1. Eyetis Foundation, Ralph K. Davies Medical Center and University of California Medical School, San Francisco

Publication History

  1. Published Online: 30 MAY 2008
  2. Published Print: 1 JAN 1973

ISBN Information

Print ISBN: 9789021940168

Online ISBN: 9780470719985



  • donor endothelium;
  • corneal graft failure;
  • surgical technique;
  • postoperative complications;
  • tissue incompatibility


Factors which play a role in the success or failure of corneal grafts include: (1) protection of donor endothelium, (2) selection of the surgical procedure, and (3) selection of the suture and suturing technique.

Injury to donor endothelium is manifested by intractable corneal oedema which appears in the immediate postoperative period.

Factors involved in the selection of the surgical technique include the type of graft, i.e. penetrating keratoplasty, the size of the corneal graft, and the extent of the surgical procedure, i.e. simple penetrating keratoplasty with or without iridectomy, combined penetrating keratoplasty with intra- or extracapsular cataract extraction, or combined penetrating keratoplasty with anterior segment revision.

The selection of suture material is directed toward using the least inflammogenic material; the choices of suturing technique depend upon the degree of inflammation, postoperative comfort for the patient, and potential visual acuity.

Each of these factors is discussed with respect to short- and long-term success and failure of the graft.