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Ophthalmology. 2011 Oct;118(10):1944-9. doi: 10.1016/j.ophtha.2011.02.023. Epub 2011 Jun 8.

Endothelial keratoplasty: the relationship between donor tissue size and donor endothelial survival.

Author information

1
Devers Eye Institute, Portland, Oregon; Lions Eye Bank of Oregon Vision Research Laboratory, Portland, OR 97210, USA. mterry@deverseye.org

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.

PMID:
21652077
DOI:
10.1016/j.ophtha.2011.02.023
[Indexed for MEDLINE]

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