Long-term endothelial cell loss and breakdown of the blood-aqueous barrier in cataract surgery

Ambrose, V M G; Walters, R F; Batterbury, Mark; Spalton, David J.; McGill, James

doi:10.1016/s0886-3350(13)81052-8

Cited by 31 publications

(10 citation statements)

References 13 publications

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“…Pseudophakic bullous keratopa- significant correlation between endothelial cell loss and recipient or donor age or pre-operative diagnosis, even in the long-term period [2,6,9,32,35,48]. In one of his publications, Kus reported an ECD of 808 ± 194 cells/mm 2 with a mean thickness of 608 ± 75 µm correlated with neither thickness nor follow-up interval [6].…”

Section: Discussionmentioning

confidence: 99%

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Assessment of endothelial cell density and corneal thickness in corneal grafts an average of 5 years after penetrating keratoplasty

Kettesy

Németh

Kemény-Beke

et al. 2014

Wien Klin Wochenschr

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SummaryBackground Corneal transparency is a useful indicator for corneal function. Our aim was to investigate central corneal endothelial cells and corneal thickness in transplanted corneas at an average of 5.4 years after penetrating keratoplastyPatients and methods The study involved 68 perforated keratoplasty patients with at least a 1 year followup. Post-operatively, the central corneal endothelial layer was observed using a contact specular microscope. Central endothelial cell density, corneal thickness and the coefficient of variation of endothelial size were statistically analysed.Results The post-operative follow-up time was ranging from 12 months to 23 years. Endothelial cell density (ECD) was 1,501 ± 249 cell/mm 2 . The average cell size was 673.6 ± 98.3 μm 2 , and the coefficient of variation of cell size was 0.61 ± 0.11. No difference in ECD was detected between diagnostic groups. Corneal thickness was 0.56 ± 0.06 mm. Correlation between ECD and post-operative time was not significant (r = 0.02; p = 0.85).Conclusion Our study concluded that ECD showed a higher rate of decrease after penetrating keratoplasty with no relation to pre-operative diagnosis.Keywords Endothelial cell loss · graft survival · penetrating keratoplasty · specular microscope Bestimmung der Endothelzelldichte und der Hornhautdicke in Hornhauttransplantaten circa 5 Jahre nach einer penetrierenden Keratoplastik Zusammenfassung Hintergrund Die Transparenz der Cornea ist ein nütz-licher Indikator der Funktion der Hornhaut. Das Ziel unserer Studie war es, die zentralen Endothelzellen der Cornea sowie die Dicke der Hornhaut in transplantierten Hornhäuten circa 5,4 (im Durchschnitt) Jahre nach penetrierender Keratoplastik zu untersuchen.Patienten und Methoden In die Studie wurden 68 Patienten nach perforierter Keratoplastik aufgenommen, die zumindest 1 Jahr nachuntersucht worden waren. Postoperativ wurde die zentrale Endothelschicht der Hornhautmittel seines Kontakt-Spekular Mikroskops untersucht. Die Dichte der zentralen Endothelzellen, die Dicke der Hornhaut und der Variations-Koeffizient der Größe des Endothels wurden statistisch analysiert.Ergebnisse Der Zeitpunkt der postoperativen Kontrollen variierte von 12 Monaten bis 23 Jahren. Die Endothelzelldichte (EZD) lag bei 1501 ± 249 Zelle/mm 2 . Der Mittelwert der Zellgröße war 673,6 ± 98,3 μm 2 und der Variationskoeffizient 0,61 ± 0,11. Es gab keinen Unterschied in der EZD zwischen den nach Diagnosen eingeteilten Gruppen. Die Korrelation zwischen der EZD und dem Zeitabstand zur Operation war nicht kant (r = 0,02; p = 0,85).Schlussfolgerung Unsere Studie zeigt unabhängig von der präoperativen Diagnose eine abfallende Tendenz der EZD nach penetrierender Keratoplastik.

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Section: Discussionmentioning

confidence: 99%

“…After intraocular surgery, the rate of endothelial cell loss is increased [2,31,32]. After cataract surgery, the rate of ECD loss increases up to 2.5 % per year during the first 10 years [33].…”

Section: Financial Interestmentioning

confidence: 99%

Assessment of endothelial cell density and corneal thickness in corneal grafts an average of 5 years after penetrating keratoplasty

Kettesy

Németh

Kemény-Beke

et al. 2014

Wien Klin Wochenschr

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“…Ambrose et al 50 measured aqueous flare using a fluorophotometer, and reported that the breakdown of BAB due to iris chafing by anterior chamber IOL influences the progression of endothelial cell loss. The breakdown of BAB can induce not only elevated cytokine levels, but also extensive alterations in the other kinds of proteins in the AqH.…”

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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“…Reports on long-term ECD alteration have suggested that decrease in ECD may result from the breakdown of the blood-aqueous barrier (BAB). 7,21 Regarding chronic inflammation of the anterior chamber, a previous study that used laser flare photometry reported a correlation between ECD and flare in the anterior chamber of eyes with a history of uveitis. 6 Elevated flare can persist in people with a history of uveitis, even after the resolution of anterior chamber cells.…”

Section: Figurementioning

confidence: 99%

“…[4][5][6] The reduction of ECD is exacerbated over time after intraocular surgery, [7][8][9] and is a serious complication after corneal transplantation because it may lead to endothelial decompensation and loss of vision. [10][11][12] Risk factors for postoperative endothelial cell loss after penetrating keratoplasty (PKP) include donor age, recipient age, graft diameter, lens status, glaucoma, graft rejection, and peripheral corneal diseases.…”

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confidence: 99%

Elevated Cytokine Levels in the Aqueous Humor of Eyes With Bullous Keratopathy and Low Endothelial Cell Density

Yamaguchi

Higa

Suzuki

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Long-term endothelial cell loss and breakdown of the blood-aqueous barrier in cataract surgery

Cited by 31 publications

References 13 publications

Assessment of endothelial cell density and corneal thickness in corneal grafts an average of 5 years after penetrating keratoplasty

Assessment of endothelial cell density and corneal thickness in corneal grafts an average of 5 years after penetrating keratoplasty

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

Elevated Cytokine Levels in the Aqueous Humor of Eyes With Bullous Keratopathy and Low Endothelial Cell Density

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