Abstract
Corneal transplantation in eyes with keratoconus is known to have an excellent prognosis for graft survival. The favorable prognosis for penetrating keratoplasty in these eyes is in large part attributed to the lack of corneal vascularization or ocular inflammation in this disorder (Arentsen 1983). In some patients with keratoconus, and in patients with pellucid marginal degeneration, which is presumed to be a related disorder (Krachmer et al. 1984), severe stromal thinning extends into the corneal periphery. Penetrating keratoplasty with standard diameter recipient beds of 7.5–8.5 mm in these patients may result in graft‐host tissue disparity, wound leaks, and high post‐keratoplasty astigmatism. Corneal grafts employing a larger than standard diameter recipient bed allows more peripheral placement of the graft‐host interface where the host cornea is less severely thinned. Placement of the graft in closer proximity to the limbal vasculature is, however, thought to increase the probability of allograft rejection reactions (Cherry et al. 1979). In this report, we present our experience with large diameter grafts for keratoconus and pellucid marginal degeneration.
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