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Abstract #50557 Published in IGR 14-2

Descemet Stripping Automated Endothelial Keratoplasty for Fuchs Endothelial Dystrophy-Influence of Graft Diameter on Endothelial Cell Loss

Anshu A; Price MO; Price FW
Cornea 2013; 32: 5-8

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PURPOSE: To evaluate the potential influence of graft diameter on endothelial cell loss after Descemet stripping automated endothelial keratoplasty. METHODS: A retrospective interventional case series of eyes treated with Descemet stripping automated endothelial keratoplasty for Fuchs endothelial dystrophy (n = 695) with at least 1-year follow-up at Price Vision Group (Indianapolis, IN) was analyzed, excluding eyes with prior glaucoma surgery. Graft diameters ranged from 7.5 to 9.5 mm, with 8.5- and 9-mm grafts accounting for the majority. Endothelial cell loss was assessed as a function of graft diameter by analysis of variance. RESULTS: Mean baseline donor endothelial cell density was 3039 cells per mm for 8.5-mm grafts (n = 225) and 3026 cells per mm for 9-mm grafts (n = 409). Mean endothelial cell density and postoperative endothelial cell loss at 1, 2, 3, 4, and 5 years was 2070 (32%), 1999 (34%), 1920 (37%), 1865 (39%), and 1617 (47%) cells per mm for 8.5-mm grafts versus 2098 (30%), 2019 (33%), 1857 (38%), 1854 (38%), and 1619 (46%) cells per mm for 9.0-mm grafts, respectively. Differences were not statistically significant at any time point. The rates of graft dislocation and immunologic rejection episode were comparable for 8.5-mm and 9.0-mm grafts (both P > 0.05). CONCLUSIONS: A larger graft diameter (9 mm) theoretically provides a larger reservoir of healthy endothelial cells but did not result in significantly less cell loss than a smaller diameter (8.5 mm) in eyes with Fuchs endothelial dystrophy during the 5-year follow-up.

*Cornea Research Foundation of America †Price Vision Group.

Full article

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Classification:

9.4.2.3 Fuchs' endothelial dystrophy (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera)
9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)

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