One-year observation of transplanted human corneal endothelium

In 34 penetrating corneal transplants, endothelial photographs were taken preoperatively and at four postoperative intervals; four days, three weeks, three months, and one year. Preoperative corneas from older donors had larger and more variably sized endothelial cells. Although the mean endothelial cell loss at the four day examination was only 17%, if continued at a linear rate so that by one year almost half of the central endothelial cells were gone. The continued cell loss was not significantly affected by the operative cell loss, the presence of a lens postoperatively, or the recipient endothelial status. Six of the 34 transplants sustained documented episodes of allograft rejection, but their endothelial cell losses were minimized by prompt treatment with corticosteroids. The cell losses in the 20 phakic and 14 aphakic transplants were similar at both the four-day and one-year intervals, although the aphakic grafts were thicker at both times. Two additional transplants with vitreous touch to the graft endothelium sustained large continuing endothelial cell losses despite maintenance of clear, thin transplants.