[Immune reactions following excimer laser and femtosecond laser-assisted penetrating keratoplasty].

In 10-20 % of conventional keratoplasties immunological graft reactions (TPR) occur, which may lead to endothelial cell loss and irreversible transplant rejection. Beside the optical advantages of non-mechanical excimer laser trephination, it does not seem to have immunological disadvantages (13.9 % TPR in keratoconus, 2.9 % in Fuchs' dystrophy after 3 years). The femtosecond laser-assisted keratoplasty has visual and refractive outcomes similar to conventional trephination. However, the "mushroom-shaped" trephination seems to have immunological disadvantages (21.8 % TPR in keratoconus after 14 months) and "top hat-shaped" keratoplasties seem to have no immunological disadvantages (6.6 % TPR in Fuchs' dystrophy after 14 months). Georg Thieme Verlag KG Stuttgart · New York.