Late complications of combined radial and transverse keratotomy after penetrating keratoplasty associated with atopic keratoconjunctivitis.

A 31-year-old man underwent bilateral penetrating keratoplasties for keratoconus. He had intolerable anisometropia postoperatively, with high irregular myopic astigmatism in the left eye. He could not wear contact lenses. A combined radial keratotomy and transverse keratotomy were performed, resulting in improved visual acuity. One year post-operatively he developed rapid vascularization of two of the radial incisions. This was associated with an acute allograft rejection, graft failure, and progressive changes in corneal topography.