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Endothelial cell loss and graft survival after penetrating keratoplasty for laser iridotomy-induced bullous keratopathy

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Abstract

Purpose

To assess corneal endothelial cell loss after penetrating keratoplasty (PK) treatment for laser iridotomy (LI)-induced bullous keratopathy (BK).

Methods

A retrospective study conducted on consecutive patients who underwent PK between March 2000 and December 2011. Patients who had undergone more than 24 months of follow-up were included. Patients who underwent PK were subcategorized into two groups based on their diagnosis of BK prior to PK; PK was performed to treat either LI-BK or non LI-BK. The cell density of the central corneal endothelium and the graft survival were evaluated during follow-up.

Results

Corneal endothelial cell density decreased in a similar fashion in both the LI-BK and non LI-BK patients, though the cell density decreased significantly faster in the LI-BK group than in the non LI-BK group throughout the 108 months of the study (p = 0.026). The mean cell loss at 36 months for the LI-BK group was 57.7% vs. 63.2% for the non LI-BK, 76.9% vs. 70.1% at 72 months, and 85.6% vs. 72.0% at 108 months. No eye among 21 eyes in the LI-BK group (0%) had failed grafts, whereas 4 of 25 eyes in the non LI-BK group (16.0%) had failed grafts at 60 months (p = 0.114).

Conclusions

The outcome of PK for BK secondary to LI was no worse than the outcome of PK for other types of BK. However, our long-term follow-up after PK showed that cell density decreased faster in the LI-BK group than in the non LI-BK, suggesting that cell loss might be involved in the existence of LI prior to PK.

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Acknowledgements

The authors wish to thank Dr. Hiroko Nakagawa for her valuable assistance with the collection of patient data, Dr. Kengo Yoshii and Mr. Ryousuke Hayashi for assistance with statistical analysis, and Mr. John Bush for editing the manuscript.

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Correspondence to Shigeru Kinoshita.

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Conflicts of interest

N. Okumura, None; A. Kusakabe, None; N. Koizumi, None; K. Wakimasu, None; K. Kayukawa, None; M. Kondo, None; K. Mori, None; C. Sotozono, None; S. Kinoshita, None.

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Okumura, N., Kusakabe, A., Koizumi, N. et al. Endothelial cell loss and graft survival after penetrating keratoplasty for laser iridotomy-induced bullous keratopathy. Jpn J Ophthalmol 62, 438–442 (2018). https://doi.org/10.1007/s10384-018-0598-1

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  • DOI: https://doi.org/10.1007/s10384-018-0598-1

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