Keratoconus, keratoplasty thickness, and endothelial morphology

Area of Science:

• Ophthalmology
• Corneal Transplantation
• Vision Science

Background:

• Keratoconus is a progressive thinning of the cornea.
• Corneal grafting is a common treatment for advanced keratoconus.
• Understanding graft behavior is crucial for long-term visual outcomes.

Purpose of the Study:

• To investigate the relationship between keratonic graft thickness and visual acuity.
• To assess graft thinning and its correlation with age and endothelial cell count.

Main Methods:

• Analysis of 51 successful keratonic grafts up to 10 years post-operation.
• Measurement of graft thickness and best-corrected visual acuity.
• In vivo endothelial cell studies on a subset of grafts.

Main Results:

• Optimal visual acuity was observed in grafts with normal corneal thickness.
• No instances of graft thinning below normal thickness were recorded.
• Endothelial cell counts as low as one-third of normal were compatible with normal acuity and thickness.

Conclusions:

• Maintaining normal graft thickness is associated with the best visual acuity after keratonic grafting.
• Keratotic grafts appear resistant to thinning over time.
• Significant reduction in endothelial cell density may not compromise graft function in the short to medium term.