Purchase this article with an account.
Tsutomu Inatomi, Hiroko Nakagawa, Kanae Miyamoto, Chie Sotozono, Shigeru Kinoshita; Comparison of corneal endothelial change post DSAEK using paired grafts from the same donor to two recipients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2701.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate the prognosis of corneal endothelium and factors affecting endothelial cell loss post Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) using paired grafts from the same donor to two recipients.
Retrospective review of 20 pairs of eyes treated by DSAEK using donor corneal grafts from the same donor. All paired donor grafts were pre-cut and used for DSAEK on the same day by the same surgeon. The pull-through technique using a Busin glide was applied for all cases. The mean patient age was 72.0±9.0 years, and the mean follow-up period was 35 months (range: 12-51 months). The primary diseases were argon laser iridotomy-induced bullous keratopathy (BK) in 17 eyes (42%), Fuchs’ corneal dystrophy in 7 eyes (18%), glaucoma surgery-related BK in 3 eyes (8%), pseudophakic BK in 3 eyes (8%), aphakic BK in 3 eyes (8%), and other disorders in 7 eyes (16%). Patients with surgical complications or graft rejection were excluded from the study. Noncontact specular microscopy (SP-3000; TOMEY Corp., Nagoya, Japan) was used to evaluate corneal endothelium at the central region.
The mean donor endothelial cell density (ECD) was 3022±134 cells/mm2 (range: 2504-3386 cells/mm2) and the mean difference of ECD in the paired corneas was 4.2% (range: 0-12%). After 1 year postoperative, 12 pairs (Group A; 24 eyes, 60%) showed similar endothelial cell loss and 8 pairs (Group B; 16 eyes, 40%) showed a more than 10% difference of endothelial cell loss. The mean difference of CED in the paired cases in Group A and Group B are 2.9% and 22.1%, respectively. In Group A, 4 paired (33%) showed matching primary diseases. However, in Group B, 7 paired (88%) showed a mismatch of the primary diseases. Six preexisting glaucoma cases in 5 pairs showed accelerated endothelial cell loss.
Donor endothelial cell viability is essential for the long-term survival of corneal endothelium post DSEAK. However, the primary diseases affect the prognosis of endothelial cell survival and preexisting glaucoma accelerates post-DSAEK endothelial cell loss.
This PDF is available to Subscribers Only