Mechanisms of Corneal Allograft Rejection and the Development of New Therapies

Effective suppression of corneal inflammation provides some insurance against subsequent graft rejection. Postoperative inflammation must be diagnosed promptly and treated energetically. Avoid high-risk corneal transplants if at all possible. A failed graft may create more problems than the original disease. There is an increasing evidence of a small benefit of tissue matching in corneal transplantation. HLA matching is recommended if logistics allow. Patients with severe visual disability and who understand the risks involved may benefit from systemic immunosuppression. When systemic immunosuppression is employed, management of the patient should be shared with a transplant physician experienced in the feld.