title: Long-Term Dehydrated Donor Lamella Survival in Anterior Keratoplasty: Keratocyte Migration and Repopulation of Corneal Stroma.
abstract: OBJECTIVE
  The aim of this study was to investigate the ability of host keratocytes to colonize the donor lamella transplanted without viable cells (dehydrated) in Descemetic (deep anterior lamellar keratoplasty) and in pre-Descemetic keratoplasty (excimer laser-assisted lamellar keratoplasty).
  
  
  METHODS
  A total of 17 eyes (8 deep anterior lamellar keratoplasties and 9 excimer laser-assisted lamellar keratoplasties) were included in this observational retrospective study; patients underwent ophthalmic examinations, and histological staining was performed ex vivo on the graft in cases of failure.
  
  
  RESULTS
  In Descemetic keratoplasty, the long-term survival of the graft is compromised with the central corneal thickness decreasing; corneal pachymetry and in vivo and ex vivo keratocyte densities are significantly reduced (pachymetric reduction of -86 μm in the apex and -87 μm in the thinnest point; density cell reduction of 72% at a depth of 100 μm, 62% at a depth of 250 μm, and -66% at a depth of 400 μm). In pre-Descemetic keratoplasty, clinical complications, reduction of central thickness, or alterations of keratocyte density were not observed.
  
  
  CONCLUSIONS
  In Descemetic keratoplasty, the migration of the host peripheral keratocytes does not seem enough to repopulate the donor graft, whereas in pre-Descemetic keratoplasty, long-term survival of the graft is good. Keratocyte repopulation was observed only by extensive contact between the donor and host parenchyma.
authors.affiliation: *Imola Eye Bank, Department of Ophthalmology, S. Maria della Scaletta Hospital, Imola, Italy; and †Pathologic Anatomy Department, S. Maria della Scaletta Hospital, Imola, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Russo
authors.forename: Paola
authors.initials: P
authors.lastname: Bonci
authors.forename: Pietro
authors.initials: P
authors.lastname: Leonetti
authors.forename: Stefania
authors.initials: S
authors.lastname: Cortecchia
authors.forename: Roberto
authors.initials: R
authors.lastname: Nannini
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002452:Cell Count; D002465:Cell Movement / Q000502:physiology*; D002470:Cell Survival / Q000502:physiology; D060527:Corneal Keratocytes / Q000166:cytology*; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000166:cytology* / Q000637:transplantation; D016039:Corneal Transplantation / Q000379:methods*; D003890:Desiccation; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors; D041623:Tomography, Optical Coherence; D066027:Transplant Recipients; D055815:Young Adult