TY - JOUR
T1 - Association of iris damage with reduction in corneal endothelial cell density after penetrating keratoplasty
AU - Ibrahim, Osama
AU - Yagi-Yaguchi, Yukari
AU - Kakisu, Koji
AU - Shimazaki, Jun
AU - Yamaguchi, Takefumi
N1 - Funding Information:
Received for publication July 1, 2018; accepted October 6, 2018. Published online ahead of print November 28, 2018. From the Department of Ophthalmology, Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan. Supported by the Grant-in-Aid for Scientific Research 15K10906 from the Ministry of Education, Culture, Sports, Science and Technology (T. Yamaguchi), Takeda Scientific Foundation (T. Yamaguchi), and Clinical Pharmacological Research Foundation (T. Yamaguchi). The funding organization had no role in the design or conduct of this research. The authors have no conflicts of interest to disclose. Correspondence: Takefumi Yamaguchi, MD, Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College 5-11-13, Sugano, Ichikawa, Chiba 272-8513, Japan (e-mail: tym.i.eye.i@gmail.com). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Purpose:To evaluate the effect of iris damage on endothelial cell loss in the early phase after penetrating keratoplasty (PKP).Methods:This prospective consecutive study included 74 patients who underwent PKP without graft rejection during the follow-up period. Endothelial cell density (ECD) was measured using specular microscopy at 1, 3, 6, and 12 months after PKP. Iris damage scores (IDSs) were determined on the basis of slit-lamp microscopy or anterior segment optical coherence tomography imaging. Graft survival rates were compared among the different IDSs. Using multivariate analysis, the factors influencing postoperative ECD were assessed, taking into consideration the presence of glaucoma, history of graft failure, donor age, and graft ECD as independent variables.Results:Graft ECD decreased from 2674 ± 329 cells/mm2 to 2114 ± 570 at 1 month, 1907 ± 629 at 3 months, 1669 ± 738 at 6 months, and 1404 ± 792 at 12 months (all, P < 0.0001). ECD at 12 months was associated with the IDS (β =-0.444, P < 0.0001), graft ECD (β = 0.309, P = 0.003), and history of graft failure (β =-0.251, P = 0.016). The IDS was significantly correlated with %ECD loss at 1 month (r = 0.427, P = 0.003), at 3 months (r = 0.376, P = 0.002), at 6 months (r = 0.301, P = 0.013), and at 12 months (r = 0.517, P < 0.0001). The graft survival rates in eyes with severe iris damage were significantly lower than those in eyes with either no or mild iris damage (P < 0.0001).Conclusions:Severe iris damage is associated with rapid reduction in ECD and graft endothelial failure after PKP.
AB - Purpose:To evaluate the effect of iris damage on endothelial cell loss in the early phase after penetrating keratoplasty (PKP).Methods:This prospective consecutive study included 74 patients who underwent PKP without graft rejection during the follow-up period. Endothelial cell density (ECD) was measured using specular microscopy at 1, 3, 6, and 12 months after PKP. Iris damage scores (IDSs) were determined on the basis of slit-lamp microscopy or anterior segment optical coherence tomography imaging. Graft survival rates were compared among the different IDSs. Using multivariate analysis, the factors influencing postoperative ECD were assessed, taking into consideration the presence of glaucoma, history of graft failure, donor age, and graft ECD as independent variables.Results:Graft ECD decreased from 2674 ± 329 cells/mm2 to 2114 ± 570 at 1 month, 1907 ± 629 at 3 months, 1669 ± 738 at 6 months, and 1404 ± 792 at 12 months (all, P < 0.0001). ECD at 12 months was associated with the IDS (β =-0.444, P < 0.0001), graft ECD (β = 0.309, P = 0.003), and history of graft failure (β =-0.251, P = 0.016). The IDS was significantly correlated with %ECD loss at 1 month (r = 0.427, P = 0.003), at 3 months (r = 0.376, P = 0.002), at 6 months (r = 0.301, P = 0.013), and at 12 months (r = 0.517, P < 0.0001). The graft survival rates in eyes with severe iris damage were significantly lower than those in eyes with either no or mild iris damage (P < 0.0001).Conclusions:Severe iris damage is associated with rapid reduction in ECD and graft endothelial failure after PKP.
KW - corneal endothelial cell
KW - iris damage
KW - penetrating keratoplasty
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U2 - 10.1097/ICO.0000000000001819
DO - 10.1097/ICO.0000000000001819
M3 - Article
C2 - 30499829
AN - SCOPUS:85061127462
SN - 0277-3740
VL - 38
SP - 268
EP - 274
JO - Cornea
JF - Cornea
IS - 3
ER -