Aqueous hyposecretion after penetrating keratoplasty.

Following penetrating keratoplasty, aqueous hyposecretion results in marked thickening of the cornea identical to that seen when the donor endothelium is unsatisfactory. The lack of secretion is accompanied by hypotony, and the persistence of fluorescein in the anterior chamber can be measured by fluorophotometry or observed clinically 24 hours after the instillation of topical fluorescein. An eye with aqueous hyposecretion will usually recover in seven to ten days, and additional surgery is not only unnecessary, but harmful to an already damaged eye. However, poor donor tissue can often be replaced promptly and successfully with repeated penetrating keratoplasty. Therefore, clinical differentiation of these conditions is important in management decisions.