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Corneal endothelium five years after transplantation
W M Bourne1, D O Hodge, L R Nelson
1Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905.
American Journal of Ophthalmology
|August 15, 1994
Summary
Corneal transplant recipients experience significant endothelial cell loss and graft failure years after surgery. This study highlights the long-term instability of corneal grafts, impacting vision and graft survival.
Area of Science:
- Ophthalmology
- Transplantation Biology
- Cell Biology
Background:
- Corneal transplantation is a common procedure to restore vision.
- Long-term graft survival and endothelial cell health are critical for successful outcomes.
Purpose of the Study:
- To evaluate the long-term endothelial cell density, morphology, and graft survival after corneal transplantation.
- To identify factors associated with endothelial cell loss and graft failure.
Main Methods:
- Prospective study of 394 corneal transplant recipients followed for five years.
- Endothelial photography and cell density measurements at multiple postoperative intervals.
- Kaplan-Meier analysis for graft rejection and failure rates.
Main Results:
- Endothelial cell density decreased by 7.8% annually between years 3 and 5 post-keratoplasty.
- Graft rejection and failure rates were 19% and 17% at five years, respectively.
- Lower cell density correlated with increased corneal thickness and higher failure risk.
Conclusions:
- Corneal grafts exhibit long-term endothelial cell instability and accelerated cell loss.
- Endothelial dysfunction contributes to stromal swelling and eventual graft failure.
- Monitoring endothelial cell health is crucial for predicting corneal transplant outcomes.