Endothelium and pachymetry of clear corneal grafts 15 to 33 years after penetrating keratoplasty.

PURPOSE: To evaluate long-term endothelial cell count and thickness of clear corneal grafts after penetrating keratoplasty.

METHODS

Specular microscopy and ultrasonic pachymetry were performed in 20 eyes (14 eyes that were keratoconus, three aphakic/pseudophakic bullous keratopathy, one Fuchs dystrophy, one had herpetic keratitis, and one avascular scar after injury) of 18 patients (mean age +/- SD 58+/-15 years; range, 34 to 82 years) with a mean follow-up of 22+/-6 years (range, 15 to 33 years).

RESULTS

Mean endothelial cell count was 808+/-194 cells per mm2 (range, 575 to 1243 cells/mm2), and thickness was 608+/-75 microm (range, 430 to 751 microm). Endothelial cell count was neither correlated with thickness (P = .25, r2 = .08) nor with follow-up interval (P = .31, r2 = .028). We observed predominantly enlarged endothelial cells and mild polymegethism. No graft rejections were recorded.

CONCLUSION

Despite a reduced cell density, the dehydration function of the endothelium may still be sufficient in corneal grafts up to 33 years after penetrating keratoplasty.