Corneal endothelial cell loss after nonmechanical ... - Springer Link

3 downloads 0 Views 42KB Size Report
115 pseudophakic and 14 aphakic eyes)] were included in this prospec- tive study. The time course of the en- dothelial cell density after PK was assessed by ...
Graefe’s Arch Clin Exp Ophthalmol (2002) 240:387–392

C L I N I C A L I N V E S T I G AT I O N

DOI 10.1007/s00417-002-0470-2

Achim Langenbucher Berthold Seitz Nhung X. Nguyen Gottfried O. H. Naumann

Received: 11 January 2002 Revised: 6 March 2002 Accepted: 6 March 2002 Published online: 16 April 2002 © Springer-Verlag 2002

A. Langenbucher (✉) · B. Seitz N.X. Nguyen · G.O.H. Naumann Augenklinik mit Poliklinik der Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany e-mail: [email protected] Tel.: +49-9131-8534052 Fax: +49-9131-8534436 URL: www.kornea.org

Corneal endothelial cell loss after nonmechanical penetrating keratoplasty depends on diagnosis: a regression analysis

Abstract Purpose: To assess the impact of diagnosis on corneal endothelial cell loss after nonmechanical penetrating keratoplasty (PK) with regression models. Methods: Five hundred eighty-nine eyes [273 with keratoconus (group I; PK only), 187 with Fuchs’ endothelial dystrophy (group II; 77 PK only and 110 triple procedures) and 129 with bullous keratopathy (group III; 115 pseudophakic and 14 aphakic eyes)] were included in this prospective study. The time course of the endothelial cell density after PK was assessed by specular microscopy. Endothelial cell density was analyzed in cross-sectional fashion at 6 and 24 months follow-up and in longitudinal manner (follow-up 2.4±1.8 years) with linear and exponential regression models (minimizing the residuum between observed and predicted endothelial cell count). Donor age, post-mortem time, storage time and ratio of organ-cultured to short-term-preserved donor corneas did not differ significantly between groups of patients. Results: In a cross section, endothelial cell den-

Introduction In non-high-risk keratoplasties the prognosis of corneal grafts has improved in the past decades due to enhanced treatment techniques and storage methods and is superior to that of all other organ transplantations [20, 21]. The primary goal after corneal transplantation is preservation

sity in group I / group II / group III decreased from 1,959±499 / 1,524±528 / 1,526±670 cells/mm2 to 1,617±553 / 1,222±520 / 1,063±384 cells/mm2 (P=0.06 / 0.04 / 0.005). Endothelial cell count was significantly higher in group I than in group II (P=0.048) and significantly higher in group II than in group III (P=0.01) at 24 months. In the linear regression model, cell count decreased in group I / group II / group III by 136±465 / 241±374 / 421±484 cells annually. In the exponential regression model, cell count decreased in group I / group II / group III by 2.9±28.0% / 11.2±21.8% / 19.3±29.4% annually. Cell loss was highly significantly lower in group I than in group II (P