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David Davis-Boozer, Collin Wulff, Jennifer Li, Jeffrey Goshe, Mark Terry; Endothelial Cell Morphology after DSAEK: Polymegathism and Pleomorphism. Invest. Ophthalmol. Vis. Sci. 2011;52(14):773.
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Corneal surgeons routinely use specular microscopy to determine post-operative endothelial cell density (ECD), but little is known about other metrics of endothelial morphology following DSAEK. This study provides a descriptive analysis of the measures of polymegathism and pleomorphism following DSAEK.
Specular microscopy was performed at 12, 24, and 36 months post-op on 372 eyes receiving DSAEK using the frame method on a Konan 3000 specular microscope. ECD, coefficient of variation in cell size (CV), and percent of six-sided cells (6A) were analyzed. Change over time was evaluated with paired-samples t-test, relationships between metrics were investigated with Chi Square test.
Mean 6A at 12, 24, and 36 months were: 35.8, 38.2, and 38.4. Mean CV were 36.5, 35.7, and 36.0. 6A improved between 12 and 24 months (p=0.002) but was stable through 36 months (p=0.776). CV remained constant throughout follow-up (p>0.05). At 24 months, 58% of patients had severe pleomorphism and only 0.2% had polymegathism. Incidence of pleomorphism was higher among patients with ECD below 2000 (p=0.001).
Pleomorphism is common among post-DSAEK grafts, especially when ECD is low. Polymegathism is rare. More research is needed to determine whether this finding is clinically significant.
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