Clinicopathological study of recipients’ corneal tissue excised during penetrating keratoplasty. Best out of waste!

Abstract

Introduction: Corneal buttons removed during penetrating keratoplasties (PK) from recipients' which were routinely discarded were studied with aim to analyze the common indications of PK and changing pattern of corneal diseases in developing countries like India. Materials and Methods: This is an observational case series carried out in tertiary care hospital of central India from October 2012 to October 2014. Histopathology of 156 corneal tissues was done of which 75 were recipients' corneal tissues removed during PK and 81 were residual adjacent donors' corneal tissues left out after corneal button was removed for transplant. Results: The most common indication of PK in our study was corneal ulcer (n=37, 49.33%), followed by infectious keratitis (n=22, 29.33%) which included ulcers in various stages of healing and complications associated with ulcer like adherent leucoma. Amongst infectious keratitis, 17 were (77.27%) of bacterial keratitis and 5 (22.73%) of fungal keratitis. Followed by bullous keratopathy 8(10.66%), 3(4%) of graft rejection and one each (1.33%) of Fuchs' dystrophy and chronic actinic keratopathy. Of 81 donor's corneal tissues, 75 were the residual corneal tissues from corneo-conjunctival junction which were transplanted within stipulated time. Only one case showed changes of chronic actinic keratopathy, rest showed normal histology. 6 corneas which were not transplanted within stipulated time showed epithelial denudation and stromal degeneration with loss of keratocytes. Conclusion: Histopathology gives additional insight to clinical diagnosis. Specific diagnosis can be commented in corneal opacities and infectious keratitis.