Thus this book impressively reflects many years of surgi­ A successful penetrating keratoplasty has many prerequi­ sites, for example suitable donor tissue, careful harvesting cal experience and can impart this to younger operating v of the donor eye and donor cornea, the possibility of suit­ surgeons and many colleagues who assist in the care of able short-term conservation, an atraumatic transplant the patients. technique using modern corneoscleral trephination instru­ Since the key to long-term visual rehabilitation of kerato­ ments as well as a problem-orientated perioperative phar­ plasty patients can be found in the knowledge presented macotherapy. All of these factors contribute to the here, we hope this book will enjoy the largest possible cir­ immediate success of the operation. More decisive for the culation. long-term success of the transplant and therefore more One is unable to conclude this preface without a word of thanks from the Department of Ophthalmology of the Uni­ important for the patient is, however, the early recognition versity of Cologne to the author for the many years during of immunogenic and non-immunogenic complications which she directed the keratoplasty consultation service. from the moment of the patient's discharge from hospital. In view of the multitude of interactions between the recipi­ These thanks are also in the name of our patients who ent eye and the donor cornea there is a complex spectrum benefited from her expert care.

1 Introduction.- 1.1 Immunological Transplant Lesions.- Literature Review.- Pathogenesis.- Predisposing Factors, Percentage Incidence.- Immune Reaction and Bilateral Keratoplasty.- 1.2 Non-immunological Surface Changes.- 1.3 Glaucoma.- 1.4 Recurrence of the Primary Disorder.- References Chapter 1.- 2 Epithelial Complications.- 2.1 Immunological Origin.- 2.2 Non-immunological Origin.- Disturbed Lacrimal Moistening.- Toxic Damage from Medication.- Mechanical Damage.- 2.3 Differential Diagnosis.- References Chapter 2.- 3 Subepithelial Complications.- 3.1 Immunological Origin.- 3.2 Non-immunological Origin.- 3.3 Differential Diagnosis.- References Chapter 3.- 4 Stromal Complications.- 4.1 Immunological Origin.- Subepithelial Infiltrates.- Superficial Necrosis.- Acute Stromal Necrosis.- 4.2 Non-immunological Origin.- Suture Infiltrates, Crystalline Infectious Keratopathy.- Ulcer Caused by Infection.- 4.3 Differential Diagnosis.- Subepithelial Infiltrates.- Superficial Necrosis.- Crystalline Keratopathy.- Stromal Necrosis.- References Chapter 4.- 5 Endothelial Complications.- 5.1 Immunological Origin.- Endothelial Function and Immune Reaction.- Endothelial Immune Reaction, Variations in Course.- Focally Progressive.- Diffuse.- 5.2 Non-immunological Origin.- Loss of Endothelial Cells (Redistribution) 55 Ingrowth of the Epithelium.- 5.3 Differential Diagnosis 56 Linear Endothelial Lesions.- Diffuse Form of Endothelial Immune Reaction - Iritis - Herpetic Iritis.- References Chapter 5.- 6 Recurrence of the Primary Disorder.- 6.1 Hereditary Corneal Dystrophies.- Stromal Corneal Dystrophies.- Granular Corneal Dystrophy.- Lattice Corneal Dystrophy.- Macular Corneal Dystrophy.- Reis-Buecklers Corneal Dystrophy.- Posterior Polymorphic Corneal Dystrophy.- 6.2 Keratoconus.- 6.3 Degenerations.- Salzmann's Corneal Degeneration.- Droplet Keratopathy.- 6.4 Herpes.- 6.5 Keratomalacia in Collagenosis.- 6.6 Differential Diagnosis.- Granular Corneal Dystrophy.- Herpes and Herpetiform Changes in the Transplant Surface.- References Chapter 6.- 7 Glaucoma.- 7.1 Acute Postoperative Rise of IOP.- 7.2 Chronic Secondary Glaucoma.- 7.3 Glaucoma in Combination with Inflammatory Lesions and Steroids.- 7.4 Diagnosis of Glaucoma.- 7.5 Differential Diagnosis.- References Chapter 7.- 8 Late Complications.- 8.1 Immunological Origin.- Epithelial Immune Reactions.- Subepithelial Infiltrates.- Stromal Necrosis.- Endothelial Immune Reactions.- Late Endothelial Khodadoust Line.- Diffusely Distributed Precipitates.- 8.2 Non-immunological Origin.- Epithelial and Surface Stroma.- Bacterial / Mycotic Keratitis.- Herpetic Keratitis.- Late Complications due to Contact Lenses.- 8.3 Surgery and Late Complications.- Suture Removal.- Intraocular Surgery.- 8.4 Ingrowth of Epithelium.- 8.5 Lens Opacities.- 8.6 Mooren's Ulcer.- 8.7 Pseudoexfoliation.- 8.8 Traumatic Wound Rupture.- References Chapter 8.- 9 Therapy.- 9.1 Systemic Therapy.- Immunosuppressants.- Steroids.- Azathioprine.- Cyclosporine A.- Virustatics.- Antibiotics.- Antiglaucomatous Agents.- 9.2 Local Therapy.- Immunosuppressants.- Steroids.- Cyclosporine A.- Virustatics.- Antibiotics, Antimycotics.- Antiglaucomatous Agents.- Lubricants.- Contact Lenses.- 9.3 Treatment in Specific Complications.- Immune Reaction.- Epithelial Immune Reaction.- Subepithelial Infiltrates.- Immunological Stromal Reaction / "Rejection Reaction".- Endothelial Immune Reaction.- Non-immunological Changes.- Surface Disorders.- Non-immunological Stromal Changes.- Endothelium - Iritis.- Aqueous Humor.- Glaucoma.- References Chapter 9.