Baseline Factors Related to Endothelial Cell Loss Following Penetrating Keratoplasty

Lass, Jonathan H.; Beck, Roy W.; Benetz, Beth Ann; Dontchev, Mariya; Gal, Robin L.; Holland, Edward J.; Kollman, Craig; Mannis, Mark J.; Price, Francis W.; Raber, Irving M.; Stark, Walter J.; Stulting, R. Doyle; Sugar, Alan

doi:10.1001/archophthalmol.2011.102

Cited by 44 publications

(50 citation statements)

References 26 publications

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“…In the current study, due to the limited number of subjects, we used Spearman correlation analyses at 6 and 12 months. However, to evaluate the correlation between ECD and the clinical/AqH factors comprehensively as previously reported, 34,58 longitudinal repeated measures analyses are more appropriate. We will increase the number of subjects and conduct longitudinal repeated measures analyses in the future.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Aqueous Cytokine Levels are Associated With Endothelial Cell Loss After Descemet's Stripping Automated Endothelial Keratoplasty

Yazu

Yamaguchi

Aketa

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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Citation: Yazu H, Yamaguchi T, Aketa N, et al. Preoperative aqueous cytokine levels are associated with endothelial cell loss after Descemet's stripping automated endothelial keratoplasty. Invest Ophthalmol Vis Sci. 2018;59:612-620. https://doi.org/ 10.1167/iovs.17-23049 PURPOSE. To evaluate the association between endothelial cell density (ECD) after Descemet's stripping automated endothelial keratoplasty (DSAEK) and preoperative cytokine levels in the aqueous humor (AqH).METHODS. This prospective consecutive case series included 97 consecutive patients who underwent DSAEK (64 eyes) or cataract surgery (33 eyes). AqH samples were collected at the beginning of each surgery. The levels of cytokines (IL-1a, IL-1b, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IFN-a, IFN-c, monocyte chemotactic protein [MCP]-1, E-selectin, P-selectin, and soluble intercellular adhesion molecule [sICAM]-1) in the AqH were measured by multiplex beads immunoassay. The correlations between preoperative aqueous cytokine levels and the ECD at 12 months after DSAEK were analyzed.RESULTS. The ECD decreased from 2747 6 259 cells/mm 2 in the donor graft to 1235 6 607 cells/mm 2 at 12 months after DSAEK. In all subjects undergoing DSAEK, the postoperative ECD at 12 months was significantly correlated with the preoperative levels of MCP-1 (r ¼ À0.467, 95% confidence interval [CI]: À0.650 to À0.222, P ¼ 0.0003). In an analysis excluding Fuchs endothelial corneal dystrophy (11 eyes), the ECD at 12 months after DSAEK was significantly correlated with preoperative levels of IL-17A (r ¼ À0.635, 95% CI: À0.819 to À0.319, P ¼ 0.0004), MCP-1 (r ¼ À0.605, 95% CI: À0.779 to À0.345, P < 0.0001), IFN-c (r ¼ À0.633, 95% CI: À0.796 to À0.385, P < 0.0001), E-selectin (r ¼ À0.516, 95% CI: À0.756 to À0.276, P ¼ 0.0004), and sICAM-1 (r ¼ À0.537, 95% CI: À0.735 to À0.253, P ¼ 0.0005).CONCLUSIONS. Higher preoperative levels of IL-17A, MCP-1, IFN-c, E-selectin, and sICAM-1 in the AqH were associated with lower ECD after DSAEK for bullous keratopathy.

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Section: Discussionmentioning

confidence: 99%

Preoperative Aqueous Cytokine Levels are Associated With Endothelial Cell Loss After Descemet's Stripping Automated Endothelial Keratoplasty

Yazu

Yamaguchi

Aketa

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…9 However, all forms of keratoplasty are associated with postoperative endothelial cell losses. [10][11][12] In the first year following Descemet's membrane endothelial keratoplasty, Descemet's stripping automated endothelial keratoplasty, and penetrating keratoplasty, endothelial cell losses have been reported as 35%, 11 14.9%, 12 and 16.5%, 10 respectively. By the third postoperative year, endothelial cell losses will have increased to approximately 47%, 11 29.7%, 13,14 and 55%, 10 respectively.…”

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confidence: 99%

Predicative Factors for Corneal Endothelial Cell Migration

Soh

Peh

George

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To characterize the effects of Descemet's stripping, Rho-associated protein kinase inhibitor Y-27632, and donor age on endothelial migration in human corneas maintained in ex vivo culture.METHODS. Twenty-eight cadaveric human corneas underwent ex vivo culture in either standard or Y-27632-supplemented culture medium for 14 days. The posterior surface of each cornea was manipulated to create two types of wounds: scratched wound-corneal endothelial cells (CECs) were denuded from the Descemet's membrane (DM) to leave behind a bare but intact DM; and peeled wound-both the DM and overlying CECs were stripped to leave behind bare corneal stroma. Endothelial migration was assessed via Trypan blue staining. Morphologic traits of CECs were assessed via Alizarin red microscopy and scanning electron microscopy.RESULTS. The CECs migrated preferentially over scratched wounds compared with peeled wounds. Y-27632 supplementation accelerated endothelial migration over scratched wounds. Endothelial migration decreased with advanced donor age for both wound types, regardless of exposure to Y-27632. Y-27632 supplementation resulted in a less rapid decline in endothelial migration for donors older than 50 years of age for scratched surfaces. Greater cell density and hexagonality was observed over scratched wounds compared with peeled wounds, regardless of Y-27632 supplementation.CONCLUSIONS. The presence of an intact DM, Y-27632 supplementation, and young donor age are factors that promote endothelial migration in an ex vivo human cornea culture model. The negative effect of age on endothelial migration can be mitigated by the presence of an intact DM and Y-27632 supplementation.

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“…Lass et al [10] observed that younger age and female gender of the donor had a significant correlation with higher ECD over time. However, cause of death and time interval from death to preservation or to surgery failed to demonstrate any significant association with changes in ECD during follow-up [10]. One study found a statistically significant negative influence of postmortem time and donor age on chronic loss of endothelial cell density after PK for keratoconus [35].…”

Section: Effect Of Donor and Eye-bank Variables On Clinical Outcomesmentioning

confidence: 97%

“…When the follow-up period was extended to 10 years, the study group observed that the donor age influenced ECD, although this finding was primarily influenced by a small group of the youngest donors (12 to < 34 years of age) that had the least cell loss and the best graft survival [34]. Lass et al [10] observed that younger age and female gender of the donor had a significant correlation with higher ECD over time. However, cause of death and time interval from death to preservation or to surgery failed to demonstrate any significant association with changes in ECD during follow-up [10].…”

Section: Effect Of Donor and Eye-bank Variables On Clinical Outcomesmentioning

confidence: 98%

“…When indicated for optical purposes, PK surgeons prefer transplanting donor cornea tissues with quality ranging from good to very good to excellent to provide adequate endothelial cells for a lifelong period. The acceptable conditions for PK donors are donor age varying from 1 to 96 years [9][10][11][12][13][14][15][16], endothelial cell density between 2000 and ≥ 3000 cells/mm In contrast to penetrating keratoplasty, donors with quality ranging from fair to excellent are employed for DALK [20,21]. Furthermore, long-term preserved donor tissues completely devoid of cells are also transplanted [22][23][24][25].…”

Section: Type and Quality Of Donors Used For Pk And Dalkmentioning

confidence: 99%

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Donor Graft Quality Used for Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty

Feizi¹

2016

Advances in Eye Surgery

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Deep anterior lamellar keratoplasty (DALK) has been recently introduced as an alternative to penetrating keratoplasty (PK) for corneal pathologies not involving corneal endothelium. DALK does not rely on donor endothelium and requires less rigid criteria for donor corneal tissue quality. Therefore, it provides a greater availability of donor corneas that do not need perfectly healthy endothelium and high endothelial cell density to be suitable for PK. Furthermore, as lamellar corneal surgery expands the potential use of acellular corneal tissue, long-term preservation techniques are being revisited as a way to increase availability of corneal tissue to alleviate constraints of availability, cost, storage, and transportation in many countries. The recent alterations in the technique of corneal transplantation and hence the type of donor cornea tissues used for each technique, may require eye banks and corneal surgeons to reassess their selection criteria but it is important for any changes to be evidence-based. The purpose of this chapter, therefore, is to present an updated analysis on the type and quality of donor corneas used for PK and DALK, to evaluate the impact of donor and eye bank variables on the suitability of corneas for transplantation and then go on to determine whether any of these donor factors affect clinical outcomes, complications, and graft survivals.

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Baseline Factors Related to Endothelial Cell Loss Following Penetrating Keratoplasty

Cited by 44 publications

References 26 publications

Preoperative Aqueous Cytokine Levels are Associated With Endothelial Cell Loss After Descemet's Stripping Automated Endothelial Keratoplasty

Preoperative Aqueous Cytokine Levels are Associated With Endothelial Cell Loss After Descemet's Stripping Automated Endothelial Keratoplasty

Predicative Factors for Corneal Endothelial Cell Migration

Donor Graft Quality Used for Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty

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