Journal
ARCHIVES OF OPHTHALMOLOGY
Volume 128, Issue 1, Pages 63-69Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/archophthalmol.2010.128.63
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Funding
- National Eye Institute [EY12728, EY12358]
- National Institutes of Health
- Department of Health and Human Services
- Eye Bank Association of America
- Bausch Lomb, Inc
- Tissue Banks International
- Vision Share, Inc
- San Diego Eye Bank
- The Cornea Society
- Katena Products, Inc
- ViroMed Laboratories, Inc
- Midwest Eye-Banks (Michigan Eye-Bank and Illinois Eye-Bank)
- Konan Medical Corp
- Eye Bank for Sight Restoration
- SightLife
- Sight Society of Northeastern New York (Lions Eye Bank of Albany)
- Lions Eye Bank of Oregon.
- NATIONAL EYE INSTITUTE [U10EY012358, U10EY012728] Funding Source: NIH RePORTER
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Objective: To determine whether preoperative and/or postoperative central endothelial cell density (ECD) and its rate of decline postoperatively are predictive of graft failure caused by endothelial decompensation following penetrating keratoplasty to treat a moderate-risk condition, principally, Fuchs dystrophy or pseudophakic corneal edema. Methods: In a subset of Cornea Donor Study participants, a central reading center determined preoperative and postoperative ECD from available specular images for 17 grafts that failed because of endothelial decompensation and 483 grafts that did not fail. Results: Preoperative ECD was not predictive of graft failure caused by endothelial decompensation (P=.91). However, the 6-month ECD was predictive of subsequent failure (P<.001). Among those that had not failed within the first 6 months, the 5-year cumulative incidence (+/- 95% confidence interval) of failure was 13% (+/- 12%) for the 33 participants with a 6-month ECD of less than 1700 cells/mm(2) vs 2%(+/- 3%) for the 137 participants with a 6-month ECD of 2500 cells/mm(2) or higher. After 5 years' follow-up, 40 of 277 participants (14%) with a clear graft had an ECD below 500 cells/mm(2). Conclusions: Preoperative ECD is unrelated to graft failure from endothelial decompensation, whereas there is a strong correlation of ECD at 6 months with graft failure from endothelial decompensation. A graft can remain clear after 5 years even when the ECD is below 500 cells/mm(2).
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