Descemet stripping automated endothelial keratoplasty for Fuchs endothelial dystrophy-influence of graft diameter on endothelial cell loss.
OBJECTIVE
To evaluate the potential influence of graft diameter on endothelial cell loss after Descemet stripping automated endothelial keratoplasty.


METHODS
A retrospective interventional case series of eyes treated with Descemet stripping automated endothelial keratoplasty for Fuchs endothelial dystrophy (n = 695) with at least 1-year follow-up at Price Vision Group (Indianapolis, IN) was analyzed, excluding eyes with prior glaucoma surgery. Graft diameters ranged from 7.5 to 9.5 mm, with 8.5- and 9-mm grafts accounting for the majority. Endothelial cell loss was assessed as a function of graft diameter by analysis of variance.


RESULTS
Mean baseline donor endothelial cell density was 3039 cells per mm for 8.5-mm grafts (n = 225) and 3026 cells per mm for 9-mm grafts (n = 409). Mean endothelial cell density and postoperative endothelial cell loss at 1, 2, 3, 4, and 5 years was 2070 (32%), 1999 (34%), 1920 (37%), 1865 (39%), and 1617 (47%) cells per mm for 8.5-mm grafts versus 2098 (30%), 2019 (33%), 1857 (38%), 1854 (38%), and 1619 (46%) cells per mm for 9.0-mm grafts, respectively. Differences were not statistically significant at any time point. The rates of graft dislocation and immunologic rejection episode were comparable for 8.5-mm and 9.0-mm grafts (both P > 0.05).


CONCLUSIONS
A larger graft diameter (9 mm) theoretically provides a larger reservoir of healthy endothelial cells but did not result in significantly less cell loss than a smaller diameter (8.5 mm) in eyes with Fuchs endothelial dystrophy during the 5-year follow-up.
Cornea Research Foundation of America, USA.
Arundhati
A
Anshu
Marianne O
MO
Price
Francis W
FW
Price
D000368:Aged; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000209:etiology* / Q000473:pathology; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery*; D006801:Humans; D008297:Male; D009929:Organ Size; D011183:Postoperative Complications; D012189:Retrospective Studies