Keratoconus and corneal transplantation: Immunogenetic features

Human leukocyte antigen (HLA) class I, II, and III proteins seem to play a role in keratoconus susceptibility. The immunogenetic features of corneal grafts were studied in 89 patients who received corneal transplants. The frequency of HLA-B21 and DR4 antigens was significantly increased in these patients, as was the phenotype association between the HLA-DR4 and BfF variants. Sixty-five of the 89 patients had corneal transplants that were not HLA matched. A protective HLA phenotype (A2, B12, and DR5) opposing graft reaction and an HLA-predisposing phenotype (B35, BfF, and DR1) were found among non-HLA matched recipients. It was interesting to note that males and non-O blood group recipients more frequently had unsuccessful graft resolution. Patient presensitization also jeopardized the success of corneal allografts.