Objectives: 

To determine the relationship between the preoperative degree of corneal edema in the recipient and the endothelial cell density in grafts after Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods: 

This retrospective case series enrolled 111 eyes of 107 patients who underwent DSAEK. The preoperative and postoperative central corneal thickness (CCT) was measured by anterior-segment optical coherence tomography. Eyes were divided into three groups according to the preoperative recipient CCT: group A (mild edema): 550 μm<CCT≤750 μm, n=38; group B (moderate edema): 750 μm<CCT≤900 μm, n=51; and group C (severe edema): 900 μm<CCT≤1,500 μm, n=22. The endothelial cell loss (ECL) was calculated by in vivo confocal microscopy and compared at 1, 6, 12, and 24 months after surgery.

Results: 

The recipient CCT (all groups combined) was 805.99±132.70 μm preoperatively and decreased to 656.31±105.02 μm at 1 month, decreased to 626.08±81.40 μm at 6 months, and remained stable between 12 (P=0.144) and 24 months (P=0.485) postoperatively. The mean ECL was 27.34±15.43%, 33.56±17.13%, 39.18±16.71%, and 45.87±14.27% at 1, 6, 12, and 24 months, respectively. The percentage of ECL in group C was higher than that in the other 2 groups through the 24-month follow-up. The difference in ECL between groups A and C was significant at 24 months (group A: 42.45±14.47%; group C: 52.49±10.65%; P=0.019).

Conclusions: 

The degree of corneal edema in the recipient was associated with implant ECL. Compared with mild and moderate corneal edema, the severe corneal edema may cause greater ECL after DSAEK.

中文翻译：

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DSAEK 后严重的角膜水肿增加了移植物的 ECL——DSAEK 后的角膜水肿和 ECL

目标： 

确定受者术前角膜水肿程度与后弹力剥离自动内皮角膜移植术 (DSAEK) 后移植物中内皮细胞密度之间的关系。

方法： 

该回顾性病例系列纳入了接受 DSAEK 的 107 名患者的 111 只眼。通过前段光学相干断层扫描测量术前和术后中央角膜厚度（CCT）。根据术前受者CCT分为3组：A组（轻度水肿）：550 μm<CCT≤750 μm，n=38；B组（中度水肿）：750 μm<CCT≤900 μm，n=51；C组（严重水肿）：900 μm<CCT≤1,500 μm，n=22。通过体内共聚焦显微镜计算内皮细胞损失 (ECL)，并在手术后 1、6、12 和 24 个月进行比较。

结果： 

受者CCT（各组合计）术前为805.99±132.70 μm，1个月时降至656.31±105.02 μm，6个月时降至626.08±81.40 μm，12个月（P=0.144）至24个月（P ）保持稳定。 =0.485 ) 术后。在 1、6、12 和 24 个月时，平均 ECL 分别为 27.34±15.43%、33.56±17.13%、39.18±16.71% 和 45.87±14.27%。随访24个月，C组ECL百分比高于其他2组。A组和C组在24个月时ECL差异有显着性（A组：42.45±14.47%；C组：52.49±10.65%；P=0.019）。

结论： 

受者角膜水肿程度与植入 ECL 相关。与轻度和中度角膜水肿相比，重度角膜水肿可能导致DSAEK后更大的ECL。