The Influencing Factors and Characteristics of Corneal Graft Endothelial Decompensation after Penetrating Keratoplasty

Abstract

Patients with different indicators for PK had different incidences and onset times for endothelial decompensation, which could help clinicians to follow-up and treat patients with PK reasonably and improve the basic research of pathogenesis of endothelial decompensation.

Risk Factors for Endothelial Decompensation after Penetrating Keratoplasty and Its Novel Therapeutic Strategies

“…The factors discussed below in specific are highly or possibly related factors in current studies. Other factors, such as race, cause of death, and method of retrieval, might not be associated with endothelial failure and changes in ECD, which are all summarized in Table 3 [3, 7, 10, 11, 16, 28, 31, 37–46].…”

“…Regarding congenital corneal endothelial dystrophy, patients have a relative high prevalence of rejection to damage the endothelium. On account of the young ages of these patients (3 to 7 years old), they tended to lack tolerance and presented early reactions more frequently [16]. Thus, these patients, along with patients with corneal trauma and eye burns, require an early follow-up to detect early complications and reduce the occurrence of endothelial decompensation.…”

“…For leucoma, fungal keratitis, and herpes simplex keratitis, PKP is relatively safe from endothelial decompensation [16]. For fungal keratitis, endothelial decompensation results from rejection, shallowness of the anterior chamber, and anterior synechia.…”

“…Since the normal function of endothelial cells is crucial for the maintenance of corneal transparency, the accumulative loss of endothelial cells might finally reach a minimum threshold, followed by functional decompensation resulting in corneal edema and opacity. This irreversible reduction in endothelial cell density (ECD) and endothelial dysfunction of the corneal graft is defined as graft endothelial decompensation [16]. For decades, many scholars have investigated the etiology of the damage to corneal endothelial cells in PKP grafts, and various risk factors were found to be associated with the process of endothelial decompensation.…”

“…For decades, many scholars have investigated the etiology of the damage to corneal endothelial cells in PKP grafts, and various risk factors were found to be associated with the process of endothelial decompensation. Although the mechanism of these risk factors remains unclear, the indication for initial PKP is an important factor affecting the incidence or even the onset time of endothelial decompensation [16]. Other factors, such as intraocular pressure (IOP), graft size, and history of diabetes of the donor, have also started to draw researchers' attention, despite the controversial results of current studies [3, 7, 10, 11].…”