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Arch Ophthalmol. 2010 Jan;128(1):63-9. doi: 10.1001/archophthalmol.2010.128.63.

Endothelial cell density to predict endothelial graft failure after penetrating keratoplasty.

Collaborators (281)

Chow CY, Dunn SP, Heidemann DG, Belin MW, Schultze RL, Oliva MS, Rotkis WM, Verdier DD, Lass JH, Reinhart WJ, Thomas JM, Hamilton SM, Jayawant GC, Lee WB, Gross RH, Shaw EL, Maskin SL, Nagra PK, Raber I, Sugar J, Tu E, Gorovoy MS, Manning FJ, Boland TS, Pascucci SE, Farjo QA, Meyer RF, Soong HK, Sugar A, Galentine PG, Ugland DN, Hannush SB, Bokosky JE, Caudill JW, Feder RS, Affeldt JC, Blanton CL, Holland EJ, Bowman RW, Cavanagh HD, El-Agha MS, McCulley JP, Gillette TE, Leahey AB, Croasdale CR, Eiferman RA, Soukiasian SH, Stulting RD, Stark W, Kenyon KR, Rodman RC, Beebe WE, Gelender H, Ching SS, Plotnik RD, Goldberg MA, Sumers KD, Fynn-Thompson NA, McColgin AZ, Raizman MB, Rosenfeld SI, Davis EA, Hardten DR, Lindstrom RL, Mannis MJ, Ford JG, Meisler DM, Dobbins K, Price FW Jr, Zeh WG, Berkowitz PJ, Lindquist TD, Goodman DF, Patel NP, Ali AM, Beatty RF, Sutphin JE, Farjo AA, Goins MM, Burris TE, Shriver PA, Self CA, Wilbanks GA, Chuck RS, Gaster RN, Kielty DW, Davis GH, Trocme SD, Van Meter WS, Smith PW, Schaeffer AR, Cohen EJ, Laibson PR, Rapuano CJ, Baratz KH, Halpern BL, Pavilack MA, Rosen GB, Doughman DJ, Pak SM, Perl T, Cowden JW, Perlman EM, Olson LE, Skoog ED, Gruzensky WD, Groos EB Jr, Mifflin MD, Lundergan MK, Berger ST, Chern KC, Solomon KD, Dennis RF, Rubenstein JB, Kostick AM, Santander SH, Roth AS, Bealer LA, Macy JI, O'Day DG, Terry MA, Sossi NP, Walter KA, Johnson FM, Mavin KL, McCoy KE, O'Keefe MB, Cole GJ, Johnston DF, Jones MA, Farazdaghi SM, Walunas EN, Montoya MM, Iliakis B, McDonald RD, Ostermiller ML, Saltwick CE, Woody JK, Weaver MH, Christ MJ, Gross MB, Engel CR, Dale RA, Hackl SK, Henriksen EJ, Kalmoe KJ, Larson JM, Malling JV, Philippy BJ, Sharpe-Cassese M, Hayes SM, Lytle RE, Rechtshaffen DA, Varnum B, Angel EB, Durell MD, Williams TR, Janssen SV, Kraus BE, McLain MB, Rossi JA, Heck EL, Hayes MS, Davis GC, Chavez TL, Oswald LD, Ruiz NB, Penta JG, Dietz WE, Nary JL, Sheriff KR, Driver NC, Faircloth WJ, Williams PE, Weber K, Barker JW, Bridges DM, Chenier L, Soper M, Allen B, Wright SJ, Martin JR, Watson AJ, McDonough G, Beilby KD, Fraser LK, Sharpe TS, Arffa RC, Tramber MA, Crow BL, Fisher MM, Stoeger CG, Jacobs E, Filbin MP, Mather JI, McGriff CM, Meinecke EE, Mason PJ, Locke GD, Reiter JF, Korroch DE, Thomas PM, Lange WA, Moore RF, Williams LJ, Friedhoff YD, Walkenbach RJ, Glover JE, Kafton BA, Lage KJ, Horn BS, Bottoms HT, Kerns ER, Jessen R, Dennis WH, Beck RW, Dontchev M, Gal RL, Kollman C, Lester LA, Mares ST, Parrimon YA, Powe AS, Ruedy KJ, Strayer HJ, Tanner JP, Lass JH, Benetz BA, Gentile C, Burke S, Edwards S, Karpinecz L, Redford M, Cotch MF, Fisher M, Bourne W, Redford M, Fishman RS, Foulks G, Musch DC, Holland EJ, Mannis MJ, Cotch MF, Dunn S, Heck E, Johnston F, Lass JH, Lindquist T, Montoya MM, Redford M, Sugar A, Sugar J, Woody J, Mannis MJ, Holland EJ, Belin MW, Dunn S, Gross RH, Gorovoy MS, Hamilton SM, Heck E, Lass JH, Lindquist T, Manning FJ, Maskin SL, Montoya MM, Raber IM, Redford M, Rotkis WM, Schultze RL, Stark WJ, Stulting RD, Sugar A, Sugar J, Tennant B, Verdier DD, Woody J, Croasdale CR, Mifflin MD, Smith PW, Sugar J.

Author information

1
Department of Ophthalmology and Visual Sciences, Case Western Reserve University and University Hospitals Eye Institute, Cleveland, Ohio, USA. cds@jaeb.org

Abstract

OBJECTIVE:

To determine whether preoperative and/or postoperative central endothelial cell density (ECD) and its rate of decline postoperatively are predictive of graft failure caused by endothelial decompensation following penetrating keratoplasty to treat a moderate-risk condition, principally, Fuchs dystrophy or pseudophakic corneal edema.

METHODS:

In a subset of Cornea Donor Study participants, a central reading center determined preoperative and postoperative ECD from available specular images for 17 grafts that failed because of endothelial decompensation and 483 grafts that did not fail.

RESULTS:

Preoperative ECD was not predictive of graft failure caused by endothelial decompensation (P = .91). However, the 6-month ECD was predictive of subsequent failure (P < .001). Among those that had not failed within the first 6 months, the 5-year cumulative incidence (+/-95% confidence interval) of failure was 13% (+/-12%) for the 33 participants with a 6-month ECD of less than 1700 cells/mm(2) vs 2% (+/-3%) for the 137 participants with a 6-month ECD of 2500 cells/mm(2) or higher. After 5 years' follow-up, 40 of 277 participants (14%) with a clear graft had an ECD below 500 cells/mm(2).

CONCLUSIONS:

Preoperative ECD is unrelated to graft failure from endothelial decompensation, whereas there is a strong correlation of ECD at 6 months with graft failure from endothelial decompensation. A graft can remain clear after 5 years even when the ECD is below 500 cells/mm(2).

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00006411.

[Indexed for MEDLINE]
Free PMC Article

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