Endothelial Cell Density Changes in Penetrating Keratoplasty (Eight Years Follow up)

Abstract

Abstract: : Purpose: To evaluate endothelial cell density changes after penetrating keratoplasty. Methods: We studied donor corneas in 73 patients who underwent penetrating keratoplasty; donor mean value age was 66.65 years (range 23–86), recipient mean value age was 61.36 (range 29–78), mean value time between donors death and tissue obtention was 6.01 hrs (range 3–8), cornea excision mean value time was 12.73 minutes (range 10–15), all tissues were introduced in corneal preservative media, chondroitin sulfate, we used the cooper vision equipment for preoperative specular microscopy, mean value time between the tissue preservation and penetrating keratoplasty was 28.71 hrs (range 11–47). We evaluated 61 patients 3 months after surgery, 42–12 months after surgery,23–4 years after surgery and 21–8 years after surgery. We distributed these donor corneas in 3 groups, Group1: Less than 50 years (9 corneas); Group 2: between 50–70 years (28 corneas), Group 3. Older than 70 years (36 corneas). Each group had two divisions; A: Donor corneas obtained before 6 hrs and B. Donor corneas obtained after 6 hrs. Results: In all groups, the cell loss percentage mean value after 3 months of surgery was 19.5%, after 1 year was 29.5%, after 4 years was 42.1% and after 8 years was 53.7%; we compared each group between themselves and no significant statistically diferences were found P>0.05; however, we compared these values against preoperative cells density and significant statistically diferences were found p>0.05. Besides no significant statistically diferences were found between 6 hrs or less obtained corneas group and older than 6 hrs group. Conclusions: Our data suggest that exist an inmediate 19.56% of cells loss mean value after penetrating keratoplasty, that this cell loss remains after 8 years (53.7%), that obtation of the donor tissue between 0–8 hrs, is not an important factor in density future changes, finally, the postoperative endothelial cell density changes is directly correlated with the preoperative cell density and not with the donor age.

Keywords: transplantation • cornea: clinical science • cornea: endothelium