Abstract
Purpose :
Intracellular dark endothelial spots (IDES) as imaged by specular microscopy are observed in various ocular/systemic conditions, including iridocorneal endothelial syndrome, uveitis, ocular trauma, diabetes mellitus, and eyes after corneal transplantation. However, the mechanism and clinical relevance of IDES remain elusive. In the current study, we evaluated the incidence of IDES after corneal transplantation (penetrating keratoplasty [PKP], Descemet's stripping automated endothelial keratoplasty [DSAEK], and Descemet's membrane endothelial keratoplasty [DMEK]) and assessed the clinical factors associated with the development of IDES.
Methods :
This study included 27 eyes (10 DSAEK, 16 PKP and 1 DMEK; 17 women and 10 men; 73.8±11.0 years, follow-up period 11.4±7.95 months). Among 27 procedures, 4 patients (14.8％, 3 PKP and 1 DSAEK) developed IDES after corneal transplantation. The presence of IDES and ECD after keratoplasty during the follow-up period was determined using specular microscopy. A correlation analysis was conducted between IDES development and clinical factors, including donor age, donor endothelial cell density (ECD), and postoperative ECD.
Results :
Donor ECD was significantly lower in eyes with IDES after corneal transplantation (2159±106 /mm2), compared to those without IDES (2535±344, P=0.027). There were no significant differences in donor age (61.7±11.3 vs73±16.3, P=0.411), visual acuity (0.572±0.509vs0.992±0.517, P=0.125), and graft survival rates (85.7 vs 100, P=0.593) between eyes with and without IDES. ECD at 6 months after corneal transplantation was significantly higher in eyes without IDES, compared to those with IDES.
Conclusions :
After corneal transplantation IDES may develop in eyes receiving grafts from lower-ECD donor tissues and have a trend of greater ECD loss. IDES can be a predictive biomarker for ECD loss after corneal transplantation.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.