For EK, which condition is acceptable for donor tissue?

• A. Tissue with infectious anterior pathology affecting the posterior stroma
• B. Tissue with non-infectious anterior pathology that does not affect the posterior stroma and endo is acceptable.
• C. Tissue with infectious posterior pathology is acceptable.
• D. Tissue with non-infectious posterior pathology is acceptable.

Answer: (B)

In endothelial keratoplasty, the graft used comes from the posterior part of the donor cornea, including the endothelium. So what matters most is the health of the posterior segment; anterior issues can be left behind during graft preparation as long as the posterior portion is disease- and infection-free. If the anterior surface has non-infectious pathology but does not involve the posterior stroma or endothelium, this tissue can still be suitable because the transplanted portion will be healthy endothelium capable of restoring corneal clarity.

Infectious disease affecting the posterior stroma or endothelium would risk transferring infection to the recipient, so those scenarios are not acceptable. Likewise, non-infectious pathology of the posterior portion implies a diseased endothelium, which would impair graft function, so that is not suitable either.