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J.S. Mehta, S. Hau, K. Bibi, B.D. Allan; Endothelial Transplantation: An In Vivo Confocal Microscopy Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1350.
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To analyze endothelial transplantation at a cellular level using a new generation in vivo confocal microscope.
We prospectively evaluated 11 endothelial transplants of 9 patients after surgery. All patients underwent slit–lamp examination, applanation tonometry and in vivo confocal microscopy (Heidelberg Retina Tomograph II, Rostock Cornea Module). Eye were classified into 2 groups: i deep lamellar endothelial keratoplasty (DLEK) group (5 eyes) ii descements stripping endothelial keratoplasty (DSEK) (6 eyes). Images were analysed in a masked manner for keratocyte density at the level of the interface and in the host and donor cornea. Depth of interface level and thickness of endothelial graft.
There were 7 females and 2 males .Mean age 75 years SD (15 ). Mean thickness of endothelial graft was 121.1microns (SD 32.4). Keratocyte count within 10 microns of the interface showed no significant difference pre/post graft (p=0.39). Keratocyte count in the reciepient and the donor 50 microns away from the interface showed significant increase in keratocyte count compared to counts at the interface (p=0.0004, p=0.00008 respectively). There was significant difference in the interface level between the DLEK and DSEK groups (p=0.0009). There was no significant correlation between the size of graft and visual acuity or duration postoperatively.
In vivo confocal microscopy study of endothelial transplanatation was able to distingush interface levels between DLEK and DSEK. The reduction in keratocyte count at the interface has important implications with respect to interface haze. This techniques offers a promising way to understand and follow up patients undergoing this procedure.
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