Abstract
Purpose To assess the corneal endothelial cell density following deep lamellar keratoplasty (DLK) carried out by air dissection and with the transplantation of lyophilised tissue.
Method Contact endothelial specular microscopy was carried out on a series of patients who had undergone DLK with a minimum of 1 year post-operative follow-up.
Results Twenty eyes of 18 patients were examined at follow-up times ranging from 1 to 8 years post-operatively (mean 3 years). Indications for surgery were: keratoconus (n = 12), herpes simplex virus (HSV) keratitis (n = 1), herpes zoster ophthalmicus (HZO) keratitis (n = 1), lipid keratopathy (n = 2), lattice dystrophy (n = 1) and corneal scarring (n = 3). Overall, mean post-operative cell density was 2417 cells/mm2 (range 928-3656 cells/mm2). In eyes with pathological conditions not likely to have affected the endothelial cell density, such as keratoconus or lattice degeneration, the mean cell density was 2837 cells/mm2 (range 1030-3656 cells/mm2).
Conclusions In patients undergoing DLK for conditions such as keratoconus the postoperative cell density was at a normal level in the majority of cases. Cell loss through this surgical intervention thus appears generally to be small. The prospect for long-term survival of these grafts is good.
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Sugita J, Kondo J . Deep lamellar keratoplasty with complete removal of pathological stroma for vision improvement. Br J Ophthalmol 1997;81:184–8.
Redmond RM, Armitage WJ, Whittle J, Moss SJ, Easty DL . Long-term survival of endothelium following transplantation of corneas stored by organ culture. Br J Ophthalmol 1992;76:479–81.
Ing JJ, Ing HH, Nelson LA, Hodge DO, Bourne WM . Endothelial cell loss ten years after penetrating keratoplasty. Invest Ophthalmol Vis Sci 1997;37:938.
Abbott R, Fine M, Guillet E . Long term changes in corneal endothelium following keratoplasty: a specular microscopic study. Ophthalmology 1983;90:676–85.
Zacks CM, Abbott RL, Fine M . Long-term changes in corneal endothelium after keratoplasty. Cornea 1990;9:92–7.
United Kingdom Transplant Support Service Authority. Cornea transplant audit 1990-1994. Bristol: UKTSSA, 1996. ISSN 1358–6564.
Bourne WM, Kaufman HE . Specular microscopy of human corneal endothelium in vivo. Am J Ophthalmol 1976;81:319–23.
Frueh BE, Bohnke M . Endothelial changes following refractive surgery. J Cataract Refract Surg 1996;22:490–6.
Archila EA . Deep lamellar keratoplasty dissection of host tissue with intrastromal air injection. Cornea 1984;3:217–8.
Chau GK, Dilly SA, Sheard CE, Rostron CK . Deep lamellar keratoplasty on air with lyophilised tissue. Br J Ophthalmol 1992;76:646–50.
Kirwan IF, Dalton R, Teimory M, Rostron CK . Deep lamellar keratoplasty: refractive results. Invest Ophthalmol Vis Sci 1996;37:S555.
Moore MB, Gebhardt BM, Verity SM, McDonald MB . Fate of lyophilized xenogenic corneal lenticules in intrastromal implantation and epikeratophakia. Invest Ophthalmol Vis Sci 1987;28:555–9.
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This work was supported by Keratec (registered charity no. 803386)
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Morris, E., Kirwan, J., Sujatha, S. et al. Corneal endothelial specular microscopy following deep lamellar keratoplasty with lyophilised tissue. Eye 12, 619–622 (1998). https://doi.org/10.1038/eye.1998.155
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DOI: https://doi.org/10.1038/eye.1998.155
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