Corneal re-grafts sometimes needed to restore the transparency after graft failure. Aim of the study is five years epidemiologic and histopathological evaluation of corneal re-grafts.

In this cross sectional study, all corneal re-grafts during 5 years (2009-2014) were assessed in the Khalili ophthalmology center at Shiraz city. Demographic data including age, area of residence, primary disease, type of graft, cause of re-graft, interval between primary and subsequent grafts (IPSG), associated eye diseases or surgeries and systemic diseases were recorded. Also, microscopic findings of corneas were reviewed.

Among total of 1190 corneal grafts, 76 of them (6.38%) were re-grafts. The most common type of grafting was penetrating keratoplasty (PK). The shortest IPSG was observed in fungal keratitis. Main causes of graft failure were endothelial dysfunction, infection, immunologic rejection, technical problems and recurrence of primary disease, respectively. The most common histopathological finding in failed grafts was severe endothelial cell loss (89.8 %). Also more than half and one third of cases had descemet membrane changes and stromal ingrowth, respectively.

Endothelial cell loss was the major cause of failure in our study. Also, recurrence rate in infective cases, especially fungal keratitis was very high. Considerable presence of histopathological changes like doubling of descemet membrane and retro corneal fibrous ingrowth need to further investigations. Perhaps modification in techniques of corneal grafting, assessment of donor tissue and recipient bed along with any need for longer medical treatment are the basis for future studies in order to increase graft survival.