Scanning Electron-Microscopical Findings of the Corneal Endothelium 40 or 57 Years after Corneal Transplantation
Werschnik C.1, Knorrn M.1, Schäferhoff C.1, Hanschke R.2, Wilhelm F.1
1Martin-Luther University Halle-Wittenberg, Department of Ophthalmology, Halle/Saale; 2Ernst-Moritz-Arndt University, Institute of SEM, Greifswald
Purpose: The good prognosis of penetrating keratoplasty in keratoconus patients is well known. There are only few reports on a very long follow-up of the behaviour of endothelial cells after transplantation.
Method: We report on two female patients with keratoconus who went for corneal transplantation 40 or 57 years ago. A second penetrating keratoplasty was indicated because of a very high astigmatism in the first case and decompensation of the corneal graft in the other case. A trepanation was performed by saving the whole corneal graft with a diameter of 4 mm, and the endothelium was investigated by scanning electron microscopy (SEM).
Results: In the 40 years old corneal graft the transition from the donor to the recipient tissue was good visible due to a thickening of the Descemet membrane. This bulge was continuously covered by endothelial cells. It is remarkable that cells located centrally were larger than those in the periphery. Fifty-seven years after transplantation there were only few cells in the center of the corneal graft. Tongues and islands of endothelial cells reached from the host to the corneal graft. Fiber-like processes of the single cells are vi
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