Corneal transplantation reaction in avascular keratoconus patients due to HLA-associated immune aberration against infection. A hypothesis.

HLA-B12 and HLA-B27 appeared to be characteristic of avascular keratoconus patients at risk of developing a corneal allograft reaction, which was mainly of late type and triggered by a nasopharyngeal infection. Equally incompatible grafts to patients with HLA-B5 had an uneventful course. This may be inference to the role of HLA-associated immune resistance factors, which necessitate the search for histocompatible corneal grafts also for avascular recipients bearing such indicators of risk.