September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Analysis of Corneal Endothelial Remodeling post Descemet`s Membrane Endothelial Keratoplasty by Scanning-Slit Wide-Field Contact Specular Microscopy
Author Affiliations & Notes
  • Tsutomu Inatomi
    Ophthalmology, Kyoto Prefectural Univ of Med, Kamigyo-Ku, Kyoto, Japan
  • Hiroshi Tanaka
    Ophthalmology, Kyoto Prefectural Univ of Med, Kamigyo-Ku, Kyoto, Japan
  • Chie Sotozono
    Ophthalmology, Kyoto Prefectural Univ of Med, Kamigyo-Ku, Kyoto, Japan
  • Shigeru Kinoshita
    Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto , Japan
  • Footnotes
    Commercial Relationships   Tsutomu Inatomi, None; Hiroshi Tanaka, None; Chie Sotozono, None; Shigeru Kinoshita, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Tsutomu Inatomi, Hiroshi Tanaka, Chie Sotozono, Shigeru Kinoshita; Analysis of Corneal Endothelial Remodeling post Descemet`s Membrane Endothelial Keratoplasty by Scanning-Slit Wide-Field Contact Specular Microscopy. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : To investigate the remodeling and migration of corneal endothelial cells (CECs) in the center and outside of the graft post Descemet`s membrane endothelial keratoplasty (DMEK), and compare the change of endothelial cell density (ECD) at the center and peripheral region by scanning-slit wide-field contact specular microscopy.

Methods : This study involved 7 eyes of 7 patients (Fuchs’ corneal dystrophy: 4 eyes; pseudo phakic bullous keratopathy: 1 eye; posterior polymorphous corneal dystrophy: 1 eye, endotheliitis: 1 eye; mean patient age: 60±10 years) treated by DMEK using internationally shipped donor corneas. Mean follow-up time was 15 months. A scanning-slit wide-field contact specular microscopy (Konan Medical, Inc.) and a non-contact specular microscope (SP-3000; TOMEY Corp.) were used to analyze CEC remodeling from the center to the peripheral region of the graft post DMEK.

Results : The mean ECD before DMEK was 2842±130 cells, yet it decreased by 45.6% to 1530 cells/mm2 at 1-year postoperative. Mean ECD at the graft center, at the graft edge sans bare stroma, and at the graft edge with bare stroma (cells/mm2±SD) at 1- and 3-months postoperative were 2047±172, 1133±76, and 1001±83, and 1925±136 , 1105±64, and 905±192, respectively. Throughout the follow-up period, ECD at the graft center was higher than that at the edge. ECD loss from 1- to 3-months postoperative at the central and edge graft regions was 15% and 20%, respectively. However, no significant difference of ECD between the bare stroma and the overlap region was found. Uneven distributions of ECD associated with surgical damage were detected in some cases, and the migration of donor CECs distinguished from the host abnormal CECs was detected toward the stripped regions.

Conclusions : Gradient and regional differences were found in the DMEK-graft ECD. CEC loss appeared in the peripheral graft region and extended to the central region during endothelial remodeling. Wound healing and endothelial migration from the donor graft to host region may affect the long-term survival of transplanted endothelium.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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