Emergence of cornea guttata in donor tissue: a cause of late graft failure

Analysis of 321 failed full-thickness corneal transplant specimens submitted for histopathological examination over a 10-year period has identified 10 instances in which the defect appeared to have been caused by the development of cornea guttata in the donor tissue. The primary condition necessitating keratoplasty in 5 of the 10 patients was Fuchs' endothelial dystrophy but, given the limited capacity of corneal endothelium for regeneration, it is considered unlikely that the defect in the grafts represented a recurrence. In 7 of 8 cases for which the duration of graft survival was known the endothelial disorder presented as a long-term event and it is assumed that the condition was not present at the time of the keratoplasty. The rare emergence of Fuchs' dystrophy in donor transplant tissue should be added to the potential causes of late graft failure.