Endothelial Cell Loss after Autologous Rotational Keratoplasty
Birnbaum F.1, Reinhard T.2, Böhringer D.1, Sundmacher R.1
1Eye Hospital, Heinrich-Heine University, Duesseldorf
2Eye Hospital, Albert-Ludwigs-University, Freiburg
Purpose: The cause of chronic endothelial cell loss after homologous keratoplasty is still unknown. Some influencing factors like donor-age, post-mortem-time and indication for keratoplasty have been identified. Some subclinical graft rejection, however, has been suspected as main cause for chronic endothelial cell loss. Comparing endothelial cell loss after homologous and autologous keratoplasty the influence of immunological factors can be estimated.
Method: Since 1988 in 19 patients autologous rotational keratoplasties were carried out. Preoperatively, in 2 patients endothelial cell density measurements could be performed. Postoperatively, in 4 patients no measurement could be performed, in 4 patients one, in 6 patients 2 and in 5 patients at least 3 measurements. For the latter 5 patients the relative annual loss of endothelial cells was calculated via an exponential regression analysis. The underlying calculations assume an exponential chronic endothelial cell loss, and are, therefore, independent of the time of the examinations. The measurements of the endothelial cell density were started on average 81.9 months postoperatively (mean; range 1.5 141 months). The results were compared with a homogeneous, historic control-group (53 patients undergoing perforating keratopla
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