Influence of Endothelial Cell Loss During Preservation on Graft Survival in Imported Donor Cornea

Kook Lee; Kyu Yeon Hwang; Man Soo Kim

doi:10.3341/jkos.2013.54.6.862

Journal List > J Korean Ophthalmol Soc > v.54(6) > 1009697

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Lee, Hwang, and Kim: Influence of Endothelial Cell Loss During Preservation on Graft Survival in Imported Donor Cornea

Original Article

J Korean Ophthalmol Soc 2013;54(6):862-868.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.6.862

Influence of Endothelial Cell Loss During Preservation on Graft Survival in Imported Donor Cornea

Kook Lee, MD, Kyu Yeon Hwang, MD, Man Soo Kim, MD

Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea

Address reprint requests to Man Soo Kim, MD Department of Ophthalmology, The Catholic University of Korea, Seoul St. Mary's Hospital #222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea Tel: 82-2-2258-6197, Fax: 82-2-599-7405, E-mail: mskim@catholic.ac.kr

Received 3 August 201227 November 2012 Accepted 13 March 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the influence of preoperative endothelial cell loss on the outcome of keratoplasty for keratoconus in imported donor corneas.

Methods

Eighteen imported corneas used in keratoplasty for keratoconus patients were evaluated. Corneal endothelial cell density at the moment of preservation was obtained from the medical records and was measured immediately before the keratoplasty. Correlation of the endothelial cell loss count before and after keratoplasty was analyzed and post-operative endothelial cell loss count according to the range of preoperative endothelial cell loss was evaluated.

Results

Mean endothelial cell loss before and after keratoplasty was 258.94 ± 128.58 cells/mm² and 355.44 ± 371.83 cells/mm², respectively. There was a positive correlation between preoperative and postoperative endothelial cell loss count (r = 0.431, p = 0.074). The results showed statistically significant higher endothelial cell loss count after keratoplasty in the range above 250 cells/mm² rather than below 250 cells/mm² of preoperative endothelial cell loss count (p = 0.033).

Conclusions

The preoperative decrease in endothelial cell density affected the endothelial cell loss after keratoplasty for keratoconus in imported donor corneas.

Keywords: Endothelial cell density, Imported donor corneas, Penetrating keratoplasty

References

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Figure 1.

Eye Bank Kerato Analyzer, Konan Medical Inc., Hyogo, Japan.

Figure 2.

Correlation between prePPKP△ CD and postPPKP△ CD (r = 0.431, p = 0.074). prePPKP△ CD = decrease in endo-thelial density before penetrating keratoplasty; postPPKP△ CD = decrease in endothelial density after penetrating keratoplasty.

Figure 3.

Correlation between prePPKP△ CD and total PPKP △CD (r = 0.519, p = 0.027). prePPKP△CD = decrease in endothelial density before penetrating keratoplasty; total PPKP △CD = decrease in endothelial density since preservation.

Table 1.

Endothelial cell density change before and after pene-trating keratoplasty

	Endothelial cell density (cells/mm²)
At preservation	2828.00 ± 257.77
Before keratoplasty	2569.06 ± 269.50
Preoperative cell loss count	258.94 ± 128.58
After keratoplasty 1 week-1 month	2586.22 ± 508.85
After keratoplasty 6 months	2230.78 ± 469.13
Postoperative cell loss count (for 6 months)	355.44 ± 371.83
Postoperative cell loss count (total)	597.22 ± 416.08

Value are presented as mean ± SD.

Table 2.

Comparison of endothelial cell density-related factors according to preoperative cell loss count

	Group 1^*	Group 2^†	p-value
Donor age (years)	58.00 ± 13.32	51.22 ± 19.37	0.400
Donor cell count (cells/mm²)	2769.44 ± 184.19	2886.56 ± 315.53	0.351
Death to preserve time (hours)	11.21 ± 8.34	9.03 ± 7.02	0.559
Preservation time (hours)	178.13 ± 41.50	182.97 ± 42.94	0.811
Death to graft time (hours)	189.33 ± 42.33	192.00 ± 43.27	0.897
Postoperative cell loss (cells/mm²)	173.00 ± 257.18	537.89 ± 390.89	0.033^‡

Value are presented as mean ± SD.

^* Preoperative cell loss count <250;

^† Preoperative cell loss count ≥250 (cells/mm²);

^‡ Statistically significant (p-value < 0.05).

Table 3.

Comparison of endothelial cell density-related factors according to range of preoperative cell loss count

	Group I^*	Group II^†	Group III^‡	p-value
Donor age (years)	49.50 ± 15.93	57.25 ± 18.45	54.50 ± 16.28	0.768
Donor cell count (cells/mm²)	2889.00 ± 228.78	2765.88 ± 221.74	2870.17 ± 338.21	0.681
Death to preserve time (hours)	11.81 ± 10.94	7.43 ± 7.01	12.58 ± 5.73	0.423
Preservation time (hours)	204.19 ± 33.90	172.57 ± 43.51	175.43 ± 42.51	0.449
Death to graft time (hours)	216.00 ± 39.19	180.00 ± 40.57	188.00 ± 44.04	0.384
Postoperative cell loss (cells/mm²)	71.00 ± 264.03	309.38 ± 241.37	606.50 ± 450.54	0.065

Value are presented as mean ± SD.

^* Preoperative cell loss count <150;

^† Preoperative cell loss count ≥150, <350;

^‡ Preoperative cell loss count ≥350 (cells/mm²).

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