Endothelial keratoplasty

The relationship between donor tissue size and donor endothelial survival

Mark A. Terry, Jennifer Li, Jeffrey Goshe, David Davis-Boozer

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Purpose: To determine if donor graft diameter has a relationship with postoperative central endothelial cell density (ECD) and survival in Descemet's stripping automated endothelial keratoplasty (DSAEK). Design: Retrospective, comparative analysis of an interventional case series. Participants: Three hundred thirty-one eyes of 243 patients undergoing DSAEK surgery for Fuchs' endothelial dystrophy without a history of rejection or graft dislocation. Methods: Descemet's stripping automated endothelial keratoplasty was performed in 331 eyes with Fuchs' dystrophy. After exclusion of confounding variables, postoperative ECD and percentage cell loss was compared for 8.0-mm grafts (n = 154) versus 8.5-mm grafts (n = 165) over a 2-year postoperative period. Main Outcome Measures: Total central ECD and percentage of donor endothelial cell loss as measured by specular microscopy of central ECD. Results: Mean preoperative ECD was 2635 cells/mm 2 for 8.0-mm grafts and 2732 cells/mm 2 for 8.5-mm grafts (P = 0.003). Mean ECD (and percent cell loss from before surgery) was 2011 cells/mm 2 (22.9%) for 8.0-mm grafts and 2078 cells/mm 2 (23.5%) for 8.5-mm grafts at 6 months, 2009 cells/mm 2 (23.3%) and 2113 cells/mm 2 (23.1%) at 1 year, and 2060 cells/mm 2 (23.4%) and 2111 cells/mm 2 (24.3%) at 2 years (P>0.72 for percentage cell loss at all time points). Conclusions: Descemet's stripping automated endothelial keratoplasty grafts with a diameter of 8.5 mm do not offer a clinical advantage over smaller 8.0-mm grafts for postoperative endothelial cell counts in the first 2 years after surgery. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

Original languageEnglish (US)
Pages (from-to)1944-1949
Number of pages6
JournalOphthalmology
Volume118
Issue number10
DOIs
StatePublished - Oct 2011
Externally publishedYes

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Corneal Transplantation
Tissue Donors
Survival
Endothelial Cells
Descemet Stripping Endothelial Keratoplasty
Transplants
Cell Count
Disclosure
Confounding Factors (Epidemiology)
Graft Rejection
Postoperative Period
Microscopy
Cell Survival
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Endothelial keratoplasty : The relationship between donor tissue size and donor endothelial survival. / Terry, Mark A.; Li, Jennifer; Goshe, Jeffrey; Davis-Boozer, David.

In: Ophthalmology, Vol. 118, No. 10, 10.2011, p. 1944-1949.

Research output: Contribution to journalArticle

Terry, Mark A. ; Li, Jennifer ; Goshe, Jeffrey ; Davis-Boozer, David. / Endothelial keratoplasty : The relationship between donor tissue size and donor endothelial survival. In: Ophthalmology. 2011 ; Vol. 118, No. 10. pp. 1944-1949.
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abstract = "Purpose: To determine if donor graft diameter has a relationship with postoperative central endothelial cell density (ECD) and survival in Descemet's stripping automated endothelial keratoplasty (DSAEK). Design: Retrospective, comparative analysis of an interventional case series. Participants: Three hundred thirty-one eyes of 243 patients undergoing DSAEK surgery for Fuchs' endothelial dystrophy without a history of rejection or graft dislocation. Methods: Descemet's stripping automated endothelial keratoplasty was performed in 331 eyes with Fuchs' dystrophy. After exclusion of confounding variables, postoperative ECD and percentage cell loss was compared for 8.0-mm grafts (n = 154) versus 8.5-mm grafts (n = 165) over a 2-year postoperative period. Main Outcome Measures: Total central ECD and percentage of donor endothelial cell loss as measured by specular microscopy of central ECD. Results: Mean preoperative ECD was 2635 cells/mm 2 for 8.0-mm grafts and 2732 cells/mm 2 for 8.5-mm grafts (P = 0.003). Mean ECD (and percent cell loss from before surgery) was 2011 cells/mm 2 (22.9{\%}) for 8.0-mm grafts and 2078 cells/mm 2 (23.5{\%}) for 8.5-mm grafts at 6 months, 2009 cells/mm 2 (23.3{\%}) and 2113 cells/mm 2 (23.1{\%}) at 1 year, and 2060 cells/mm 2 (23.4{\%}) and 2111 cells/mm 2 (24.3{\%}) at 2 years (P>0.72 for percentage cell loss at all time points). Conclusions: Descemet's stripping automated endothelial keratoplasty grafts with a diameter of 8.5 mm do not offer a clinical advantage over smaller 8.0-mm grafts for postoperative endothelial cell counts in the first 2 years after surgery. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.",
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