The analysis of density of endothelium cells in medium-term period of observation after endothelium keratoplastry with formation of transplant using femtosecond laser from the side of endothelium

Abstract

The article presents the results of analysis of loss of density of endothelium cells after endothelium keratoplastry with formation of ultra-thin transplant using femtosecond laser from side of endothelium (UTinvFS-DSEK). The study sampling included 22 patients underwent UTinvFS-DSEK during 2012-2014 in the Helmholtz Moscow research institute of eye diseases. The average time-period of observation made up to 9.6 ± 4.3 months. The Fuchs dystrophy occurred in 31.8%, secondary dystrophy - in 45.4%, inconsistency of endothelium of kerato-transplant - in 22%. All patients were applied photo-registration, visiometry, auto-refractokeratometry, bio-microscopy, tonometry, kerato-analyzing, optical coherent tomography of front segment, confocal microscopy. During the first three years after transplantation, the average loss by endothelium cells made up to 60% of initial level. At that, average loss of density of endothelium cells made up to 1256 ± 450 cells per mm2. In time-periods of six months after surgery the average loss of density of endothelium cells made up to 64% of initial level. The loss of density of endothelium cells remained at the level of 64% after 12 months. In two patients under observation the average density of endothelium cells made up to 996±161 cells per mm 2 after 24 months. The analysis of dynamics of loss by endothelium cells after applied keratoplastry with formation of transplant using femtosecond laser from the side of endothelium demonstrated that received values of loss by cells in existing time-periods exceed, according publications' data, similar indicator after reach-through keratoplastry, standard endokeratoplastry and transplantation of Descemet's membrane with endothelium. The actual study has such certain limitations as average time-periods of observation, limited number of patients, minimal number of patients within time-period more than 24 months.