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Paolo Sivelli, Jennifer Cattaneo, Elena Cavalli, Andrea Galli, Diego Ponzin, Claudio Azzolini; Endothelial Cell Loss After Glide Descemet Stripping Automated Endothelial Keratoplasty: An In Vivo Evaluation With Confocal Microscopy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6448.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze, using confocal microscopy, the depletion of endothelial cells in patients who have been previously treated with endothelial corneal transplant using glide descemet stripping automated endothelial keratoplasty DSAEK.
13 patients were included in the study; 7 (53.8%) men and 6 (46.1%) women. Ages ranged from 60 to 83 years with a mean age of 73. 9 patients (69%) were affected by Fuchs' endothelial dystrophy whilst 4 patients (31%) had developed a pseudophakic bullous keratopaty as a consequence of cataract phacoemulsification. All patients underwent endothelial transplantation with DSAEK technique. During the post-operative follow-up, all patients underwent an endothelial cells count using confocal microscopy (Nidek, Confoscan 4) at months 1, 3 and then after 1 year. The obtained results were compared to the endothelial density value of all donor corneas which was indicated from the Veneto Eye Bank before surgery .
The endothelial density mean value detected by the Eye Bank before surgery was 2713 cell/mm (max 3100 - min 2400). At first month after surgery the number of endothelial cells in the donor cornea patch was 1560 cell/mm (min 460 max 2495), at 3 months 1221 cell/mm (min 450 max 2100) and at a year 1097 cell/mm (min 235 max 1700). The loss of endothelial cells after DSAEK surgery is 42.5% during first month, a further 21.7% at third month and another 10% between third month and a year after surgery.
A maximum depletions of cells was found one month after surgery (42.5%). The process of cell death in the transplanted corneal donor patch greatly decreased until becoming stable between third months and one year after surgery. Even though the glide technique significantly reduces cell loss compared with other similar techniques, there is still room for improvement.
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