J Korean Ophthalmol Soc.  2011 Jul;52(7):807-815. 10.3341/jkos.2011.52.7.807.

Analysis of Factors Affecting Corneal Endothelial Cell Loss after Penetrating Keratoplasty

• Kim TK
• Byun YS
• Kim MS

• KMID: 2214705
• DOI: http://doi.org/10.3341/jkos.2011.52.7.807

Abstract

PURPOSE
To evaluate the factors affecting corneal endothelial cell loss after penetrating keratoplasty in a long-term follow-up.
METHODS
Donor age, post-mortem time, storage time, underlying disease, elevation of IOP after surgery, underlying glaucoma, and trephine size were analyzed in 76 eyes. Postoperative corneal endothelial density was measured after 1, 3, 6, and 12 months. Patients who experienced graft rejection were excluded.
RESULTS
Donor age and endothelial loss were correlated in all patients (t-value = 1.98); however, post-mortem time and storage time were not statistically significant (t 2 < 2). Endothelial cell loss was more severe in the bullous keratopathy patient group than it was in the keratoconus patient group, but this difference was not statistically significant (p-value = 0.154). The number of anti-glaucomatous eye drops showed positive correlation with the declining rate of endothelial cells (t-value = 1.975). Existence of glaucoma diagnosed before surgery did not statistically influence endothelial cell loss. Additionally, in the bullous keratopathy patient group, an inverse correlation between endothelial cell loss and trephine diameter was observed (t-value = -2.859).
CONCLUSIONS
Old donor age, small trephine size in bullous keratopathy, and post-operative IOP elevation are risk factors for increased endothelial cell loss following penetrating keratoplasty.

Keyword

Donor age; Endothelial cell; Glaucoma; Penetrating keratoplasty; Trephine diameter

MeSH Terms

Corneal Endothelial Cell Loss
Endothelial Cells
Eye
Glaucoma
Graft Rejection
Humans
Keratoconus
Keratoplasty, Penetrating
Ophthalmic Solutions
Risk Factors
Tissue Donors
Ophthalmic Solutions

Figure

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  Figure 1. Distribution of postoperative IOP elevation in three groups. Postoperative IOP elevation is observed in 18.18% of group 1, 60.6% of group 2, 21.21% of group 3. IOP = intraocular pressure.

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  Figure 2. Trend of loss of endothelial cell density (ECD) according to trephine size in bullous keratopathy patients group.

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