Abstract
Purpose :
The donated corneas used in Penetrant Keratoplasty (PK) lose approximately 50% of endothelial density in the first 5 years, after the EC loss decline. Considering specular microscopy exams, there is no report in literature of the behavior of the endothelial mosaic (EM) cells on the receptor disc of patients with PK by keratoconus (KC) in which EC is normal. Purpose: To know the profile of the endothelium of transplanted corneas more than 5 years , comparing the EM cells of the donated corneas with the EM cells of the recipient corneal ring (Figure 1A).
Methods :
Cross sectional study of 24 eyes more than 5 years after PK of the Prof. Dr. Fernando Abib Eye Clinic. The sampling error (Reliability Degree 95% and Relative Error < 0.05) of each CSM as well as the number of EM images included in the exam in each of these two sectors, Donor Disc and Recipient Ring, was determined by the software Cells Analyzer (Patent USA). Contact BioOptics 2500 Bambi Corneal Specular Microscopy (CSM) (BioOptics, USA) to evaluate of the endothelial mosaic (EM) at the Donor Disc (DD Group) and at the Recipient Ring (RR Group) (Figure 1A) comparing Endothelial Cell Density (ECD), Coeficient of Variation (CV), and hexagonal cells (% HEX). Comparisons of DD Group with RR Group: The t Student test was used at p<0.05. Statistical software Core Team 3.6.3.
Results :
Age 32 - 69 yeras old, average 44,1±8,7 years old. Time between PK - CSM 5 -29 years, average 12,8±6,9 years. Number of EM images per exam: DD Gorup 3 - 17, average 9,1±3,3 and RR Group 1 - 5, average 2,4±1,2. There is no difference of ECD, CV, and % HEX in EM cells in the studied groups (Figure 1C and Figure 2A, 2B, 2C). The figure 1B shows the EM at RR and DD of the one studied eye.
Conclusions :
There is no difference in EM between RR and DD in patients with PK with more than 5 years. It’s suggests that the high cellular loss of RR, because the EM of KC patient is normal. This cell loss must be related to the canyon effect caused by the EM unevenness of the scar between the surfaces of the RR and DD.
This is a 2021 Imaging in the Eye Conference abstract.