Endothelial Cell Loss Following Stromal Rejection After Deep Anterior Lamellar Keratoplasty: A Retrospective Case-Control Study
Published 2024 - 42nd Congress of the ESCRS
Reference: FP31.09 | Type: Free paper | DOI: 10.82333/np9x-mg50
Authors: Luca Furiosi* 1 , Chiara Vivarelli 1 , Angeli Christy Yu 1 , Rossella Spena 1 , Cristina Bovone 2 , Massimo Busin 1
1Department of Translational Medicine,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì "Villa Igea",Forlì,Italy, 2Department of Environmental Sciences and Prevention,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì "Villa Igea",Forlì,Italy
Purpose
To compare the endothelial cell loss after deep anterior lamellar keratoplasty (DALK) in patients with and without stromal rejection.
Setting
Ospedali Privati Forlì “Villa Igea”, Forlì, Italy.
Methods
This retrospective case-control study was conducted at a single tertiary-referred center (Ospedali Privati Forlì “Villa Igea”). A hospital-based age-, sex- and diagnosis-matched patients was enrolled with a case-control ratio of 1:2. Thirty-three patients who developed stromal rejection after DALK and sixty-five matched subjects without stromal rejection after deep anterior lamellar keratoplasty were included. Main outcome measures were endothelial cell loss and best spectacle-corrected visual acuity (BSCVA).
Results
The average age was 37 ± 13.9 years in case group and 36.7 ± 12.7 years in control group. Case group included 24 male and 9 female, compared with 48 male and 17 female in control group. In both groups the most frequent diagnosis was keratoconus (83%). Before stromal rejection, no statistically significant difference in endothelial cell count was observed between the two groups. Patients after stromal rejection showed significantly lower endothelial cell count compared to controls. In addition, patients who experienced stromal rejection after DALK presented significantly lower endothelial cell count also at last follow-up compared to controls. No difference in final BSCVA was found between study eyes and control subjects at last follow-up.
Conclusions
Our results suggest that stromal rejection is associated with endothelial cell loss after DALK. Prompt diagnosis and adequate therapy is required to avoid the irreversible loss of endothelial cell loss.