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Background  It has been shown experimentally in rodents that removal of the spleen leads to increased rejection of corneal allografts after corneal transplantation (keratoplasty).    Case presentation  Here, we report a unique case of a splenectomized patient with corneal endothelial dystrophy who underwent posterior lamellar keratoplasty. During follow-up of 4 years, we did not detect any signs of corneal allograft rejection.    Conclusions  Our report indicates that an intact spleen is not necessary for allograft acceptance after posterior lamellar keratoplasty. To the best of our knowledge, this is the first report of a splenectomized patient receiving a (lamellar) corneal transplant.

Does anterior chamber-associated immune deviation (ACAID) play a role in posterior lamellar keratoplasty? Case report of a splenectomized patient