Mooren's ulcer and evidence of stromal graft rejection after penetrating keratoplasty

J. D. Gottsch, S. H. Liu, W. J. Stark

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26 Scopus citations


A Mooren's ulcer developed in a 6-year-old girl after a penetrating keratoplasty for Peters' anomaly. A destructive, circumferential, and centripetal stromal ulceration recurred despite conjunctival resection, corneal gluing, topical and systemic administration of corticosteroids, and repeat graftings. Results of a systemic and a rheumatologic examination were unremarkable. Histopathologic evaluations of donor grafts consistently disclosed a lymphocytic and a plasma cell infiltrate. Indirect immunofluorescent staining using a normal donor cornea substrate was positive at the level of Bowman's membrane and stroma. The patient's lymphocytes were stimulated by a partially purified bovine corneal antigen and a positive antibody titer was found in the patient's sera to the same corneal antigen. These results suggest humoral and cell-mediated immune mechanisms can be involved in the initiation and perpetuation of a stromal rejection process after penetrating keratoplasty.

Original languageEnglish (US)
Pages (from-to)412-417
Number of pages6
JournalAmerican journal of ophthalmology
Issue number4
StatePublished - 1992

ASJC Scopus subject areas

  • Ophthalmology


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