Posterior Chamber Lens Implantation after Penetrating Keratoplasty Contributing Factor to Late Endothelial Graft Failure?
Böhringer D.1, Reinhard T.2, Sundmacher R.1
1Eye hospital, Heinrich-Heine-University, Düsseldorf
2Eye Hospital, Albert-Ludwigs-University, Freiburg
Purpose: Posterior chamber lens implantations (PCL) after penetrating keratoplasty (pKp) might contribute to late endothelial graft failure due to intraoperative damage of graft endothelium or due to PCL-associated facilitation of chronic endothelial cell loss.
Method: 49 eyes that had been phakic and only suffering from Fuchs endothelial dystrophy prior to pKp were retrospectively selected. Factors such as glaucoma and graft rejections that contribute to endothelial cell loss had been exclusion criteria. Central endothelial cell density was recorded 5 times within follow-up (mean 3,5±1,4 years). By means of exponential regression analysis, individual annual relative endothelial cell loss was calculated. Due to advanced cataract, on 18 patients (group A) a combined operation (triple-procedure) had been performed on initially. 17 of the remaining 31 eyes underwent PCL-implantation after in mean 1,5±1,2 years post pKp within follow-up (group B). The remaining 14 eyes kept phakic within follow-up (group C). Neither follow-up, donor age, storage time in organ culture nor death to excision time differed significantly over groups. All procedures had been performed by only three experienced surgeons.
Results: Mean individual annual relative l
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