Epithelial downgrowth leading to graft rejection after penetrating keratoplasty

Fernando Godin, Carolina Mercado (Coresponding Author), Pablo Larco, Maria A. Pacheco L, Davide Borroni, Alberto Chacon Aponte

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Purpose: To report a case of epithelial downgrowth after penetrating keratoplasty. Case description: A 58-year-old man presented with graft rejection in his three-month-old, repeat penetrating keratoplasty. Examination revealed centripetal opacification of the posterior cornea due to deep epithelization. He had new retro-corneal membranes and anterior uveitis. Specular microscopy and anterior segment optical coherence tomography were performed, and a clinical diagnosis of epithelial downgrowth was made. The patient had intracameral injections with 5-fluorouracil (5FU) and achieved resolution of intraocular findings after treatment. Conclusions: Epithelial downgrowth is an uncommon complication of penetrating keratoplasty. It affects the patients’ visual acuity and graft survival. Clinical observation is preferred in severe cases due to the high risk of intraocular damage; intracameral 5FU promises to be a good option in these cases.

Original languageEnglish
Pages (from-to)NP5-NP8
JournalEuropean Journal of Ophthalmology
Issue number4
Publication statusPublished - May 2023


  • corneal transplant
  • epithelial downgrowth
  • intracameral chemotherapy
  • retro-corneal membranes

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


Dive into the research topics of 'Epithelial downgrowth leading to graft rejection after penetrating keratoplasty'. Together they form a unique fingerprint.

Cite this