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Y.–F. Yao, Y.–F. Ye, W.–Y. Qiu, Y.–M. Zhang, P. Zhou, B. Zhang; Regeneration of Corneal Endothelium Restored Corneal Graft Clarity in Eyes After Therapeutic Penetrating Keratoplasty Using Cryopreserved Donor Tissue in Three Patients . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2354.
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To report regeneration of corneal endothelial cells on the grafts in three patients who received therapeutic penetrating keratoplasty using cryo–preserved donor tissue without endothelium.
To preserve the anatomic integrity of the eyeballs, therapeutic penetrating keratoplasty using cryopreserved donor tissue without endothelium was performed for three patients who exhibited corneal perforation due to fungal keratitis, herpetic keratitis and ocular thermal burn, respectively. Postoperatively, periodical slit lamp microscopy, A–ultrasonic pachymetery and in vivo confocal microscopy were carried out to observe inflammation changing of the eyes, and variations of corneal thickness and reappearance of corneal endothelial cells on the donor corneal grafts in the eyes of the three patients.
Postoperatively, inflammation of the eyes gradually regressed within one month and resolved within three months. During a certain period in one to six months postoperatively, remarkable corneal edema of the grafts was observed in the eyes of the three patients, and meanwhile, no corneal endothelial cells were detected on the grafts by confocal microscopy. Thereafter, gradual and progressive regression of stromal edema and finally recovery of the normal corneal thickness associated with restoration of corneal clarity of the grafts were observed in the eyes of the three patients. Through periodical in vivo confocal microscopy, regeneration of a new corneal endothelium with fairly high cell density (range from 1100 to 1500 cells/mm) on the grafts was substantiated in the eyes of the three patients.
This is the first report offering definite evidence that corneal endothelial cells deriving from peripheral recipient side can regenerate to form a new endothelium on the grafts in patient eyes. The regenerated corneal endothelium on the grafts reaches fairly high cell density and exerts integrity of endothelial function to restore normal dehydrated state of the stroma and recover the corneal graft clarity.
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