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Asem A. Alqudah, Mark A. Terry, Michael Straiko, Mark Greiner, David Davis-Boozer; Endothelial Keratoplasty: The Relationship Between Six Month Postoperative Endothelial Cell Density And Graft Survival. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6023.
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To determine if the six months postoperative central Endothelial Cell Density (ECD) has a relationship with the overall survival of the graft Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK).
Descemet's stripping automated endothelial keratoplasty was performed in 598 eyes with Fuchs' dystrophy. The eyes were then divided into two groups based on six-month ECD. Group 1 had an ECD < 2000 (265 eyes) and Group 2 had an ECD >= 2000 (333 eyes) at the six months postoperative visit. Kaplan Meier survival analysis was performed, and long-term survival rates were compared between the two groups using the Mantel-Cox Log Rank test. Follow-up time ranged from 184 to 2250 days.
Mean 6-month ECD for group 1 was 1672 (36.8 % loss from pre-op), and 2306 for Group 2 (15.4% loss). There was a total of 5 graft failures, all within Group 1. Time to failure ranged from 184 to 1540 days. Graft survival rate was 98.1% for Group 1 and 100% for Group 2 (P = 0.016).
In Descemet's stripping automated endothelial keratoplasty grafts, low ECD at six months post-op can be predictive of reduced graft survival.
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