Donor age and factors related to endothelial cell loss 10 years after penetrating keratoplasty: Specular Microscopy Ancillary Study
To examine the effect of donor age and other perioperative factors on long-term endothelial cell loss after penetrating keratoplasty (PKP). Multicenter, prospective, double-masked clinical trial. We included 176 participants from the Cornea Donor Study cohort who had not experienced graft failure ≥...
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Veröffentlicht in: | Ophthalmology (Rochester, Minn.) Minn.), 2013-12, Vol.120 (12), p.2428-2435 |
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creator | Lass, Jonathan H Benetz, Beth Ann Gal, Robin L Kollman, Craig Raghinaru, Dan Dontchev, Mariya Mannis, Mark J Holland, Edward J Chow, Christopher McCoy, Kristen Price, Jr, Francis W Sugar, Alan Verdier, David D Beck, Roy W |
description | To examine the effect of donor age and other perioperative factors on long-term endothelial cell loss after penetrating keratoplasty (PKP).
Multicenter, prospective, double-masked clinical trial.
We included 176 participants from the Cornea Donor Study cohort who had not experienced graft failure ≥ 10 years after PKP for a moderate risk condition (principally Fuchs' dystrophy or pseudophakic/aphakic corneal edema).
Corneas from donors 12 to 75 years old were assigned to participants using a randomized approach, without respect to recipient factors. Surgery and postoperative care were performed according to the surgeons' usual routines. Images of the central endothelium were obtained preoperatively and at intervals for 10 years postoperatively. Images were analyzed by a central image analysis reading center to determine endothelial cell density (ECD).
Endothelial cell density at 10 years.
Among study participants with a clear graft at 10 years, the 125 who received a cornea from a donor 12 to 65 years old experienced a median cell loss of 76%, resulting in a 10-year median ECD of 628 cells/mm(2) (interquartile range [IQR], 522-850 cells/mm(2)), whereas the 51 who received a cornea from a donor 66 to 75 years old experienced a cell loss of 79%, resulting in a median 10-year ECD of 550 cells/mm(2) (IQR, 483-694 cells/mm(2); P adjusted for baseline ECD = 0.03). In addition to younger donor age, higher ECD values were significantly associated with higher baseline ECD (P |
doi_str_mv | 10.1016/j.ophtha.2013.08.044 |
format | Article |
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Multicenter, prospective, double-masked clinical trial.
We included 176 participants from the Cornea Donor Study cohort who had not experienced graft failure ≥ 10 years after PKP for a moderate risk condition (principally Fuchs' dystrophy or pseudophakic/aphakic corneal edema).
Corneas from donors 12 to 75 years old were assigned to participants using a randomized approach, without respect to recipient factors. Surgery and postoperative care were performed according to the surgeons' usual routines. Images of the central endothelium were obtained preoperatively and at intervals for 10 years postoperatively. Images were analyzed by a central image analysis reading center to determine endothelial cell density (ECD).
Endothelial cell density at 10 years.
Among study participants with a clear graft at 10 years, the 125 who received a cornea from a donor 12 to 65 years old experienced a median cell loss of 76%, resulting in a 10-year median ECD of 628 cells/mm(2) (interquartile range [IQR], 522-850 cells/mm(2)), whereas the 51 who received a cornea from a donor 66 to 75 years old experienced a cell loss of 79%, resulting in a median 10-year ECD of 550 cells/mm(2) (IQR, 483-694 cells/mm(2); P adjusted for baseline ECD = 0.03). In addition to younger donor age, higher ECD values were significantly associated with higher baseline ECD (P<0.001) and larger donor tissue size (P<0.001). Forty-two of the 176 participants (24%) had an ECD of <500 cells/mm(2) at 10 years and only 24 (14%) had an ECD of >1000 cells/mm(2).
Substantial cell loss occurs in eyes with a clear graft 10 years after PKP, with the rate of cell loss being slightly greater with older donor age. Greater preoperative ECD and larger donor tissue size are associated with higher ECD at 10 years.</description><identifier>EISSN: 1549-4713</identifier><identifier>DOI: 10.1016/j.ophtha.2013.08.044</identifier><identifier>PMID: 24246826</identifier><language>eng</language><publisher>United States</publisher><subject>Adolescent ; Adult ; Aged ; Aging - pathology ; Cell Count ; Child ; Corneal Edema - physiopathology ; Corneal Edema - surgery ; Corneal Endothelial Cell Loss - diagnosis ; Corneal Endothelial Cell Loss - etiology ; Corneal Endothelial Cell Loss - physiopathology ; Double-Blind Method ; Endothelium, Corneal - pathology ; Eye Banks ; Female ; Fuchs' Endothelial Dystrophy - physiopathology ; Fuchs' Endothelial Dystrophy - surgery ; Graft Survival - physiology ; Humans ; Keratoplasty, Penetrating ; Male ; Middle Aged ; Postoperative Complications ; Prospective Studies ; Risk Factors ; Time Factors ; Tissue Donors ; Young Adult</subject><ispartof>Ophthalmology (Rochester, Minn.), 2013-12, Vol.120 (12), p.2428-2435</ispartof><rights>Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24246826$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lass, Jonathan H</creatorcontrib><creatorcontrib>Benetz, Beth Ann</creatorcontrib><creatorcontrib>Gal, Robin L</creatorcontrib><creatorcontrib>Kollman, Craig</creatorcontrib><creatorcontrib>Raghinaru, Dan</creatorcontrib><creatorcontrib>Dontchev, Mariya</creatorcontrib><creatorcontrib>Mannis, Mark J</creatorcontrib><creatorcontrib>Holland, Edward J</creatorcontrib><creatorcontrib>Chow, Christopher</creatorcontrib><creatorcontrib>McCoy, Kristen</creatorcontrib><creatorcontrib>Price, Jr, Francis W</creatorcontrib><creatorcontrib>Sugar, Alan</creatorcontrib><creatorcontrib>Verdier, David D</creatorcontrib><creatorcontrib>Beck, Roy W</creatorcontrib><creatorcontrib>Writing Committee for the Cornea Donor Study Research Group</creatorcontrib><title>Donor age and factors related to endothelial cell loss 10 years after penetrating keratoplasty: Specular Microscopy Ancillary Study</title><title>Ophthalmology (Rochester, Minn.)</title><addtitle>Ophthalmology</addtitle><description>To examine the effect of donor age and other perioperative factors on long-term endothelial cell loss after penetrating keratoplasty (PKP).
Multicenter, prospective, double-masked clinical trial.
We included 176 participants from the Cornea Donor Study cohort who had not experienced graft failure ≥ 10 years after PKP for a moderate risk condition (principally Fuchs' dystrophy or pseudophakic/aphakic corneal edema).
Corneas from donors 12 to 75 years old were assigned to participants using a randomized approach, without respect to recipient factors. Surgery and postoperative care were performed according to the surgeons' usual routines. Images of the central endothelium were obtained preoperatively and at intervals for 10 years postoperatively. Images were analyzed by a central image analysis reading center to determine endothelial cell density (ECD).
Endothelial cell density at 10 years.
Among study participants with a clear graft at 10 years, the 125 who received a cornea from a donor 12 to 65 years old experienced a median cell loss of 76%, resulting in a 10-year median ECD of 628 cells/mm(2) (interquartile range [IQR], 522-850 cells/mm(2)), whereas the 51 who received a cornea from a donor 66 to 75 years old experienced a cell loss of 79%, resulting in a median 10-year ECD of 550 cells/mm(2) (IQR, 483-694 cells/mm(2); P adjusted for baseline ECD = 0.03). In addition to younger donor age, higher ECD values were significantly associated with higher baseline ECD (P<0.001) and larger donor tissue size (P<0.001). Forty-two of the 176 participants (24%) had an ECD of <500 cells/mm(2) at 10 years and only 24 (14%) had an ECD of >1000 cells/mm(2).
Substantial cell loss occurs in eyes with a clear graft 10 years after PKP, with the rate of cell loss being slightly greater with older donor age. Greater preoperative ECD and larger donor tissue size are associated with higher ECD at 10 years.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aging - pathology</subject><subject>Cell Count</subject><subject>Child</subject><subject>Corneal Edema - physiopathology</subject><subject>Corneal Edema - surgery</subject><subject>Corneal Endothelial Cell Loss - diagnosis</subject><subject>Corneal Endothelial Cell Loss - etiology</subject><subject>Corneal Endothelial Cell Loss - physiopathology</subject><subject>Double-Blind Method</subject><subject>Endothelium, Corneal - pathology</subject><subject>Eye Banks</subject><subject>Female</subject><subject>Fuchs' Endothelial Dystrophy - physiopathology</subject><subject>Fuchs' Endothelial Dystrophy - surgery</subject><subject>Graft Survival - physiology</subject><subject>Humans</subject><subject>Keratoplasty, Penetrating</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Tissue Donors</subject><subject>Young Adult</subject><issn>1549-4713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kM1OwzAQhC0kREvhDRDykUuDHTuOw63iXwJxAM7R1t60KW4cbOeQMy9OEHCa0ejTaHcIOeMs44yry13m-23aQpYzLjKmMyblAZnzQlZLWXIxI8cx7hhjSgl5RGa5zKXSuZqTrxvf-UBhgxQ6SxswyYdIAzpIaGnyFDvr0xZdC44adI46HyPljI4IEwlNwkB77DAFSG23oR84Gd87iGm8oq89msFBoM-tCT4a34901ZnWTdlIX9NgxxNy2ICLePqnC_J-d_t2_bB8erl_vF49Lfuc87SUErjQpZFNbgUYrSvFbGMEKKxK01idl2srC23UtEmhQK8LZtaNaDhUJWopFuTit7cP_nPAmOp9G39egg79EGsui6oqi6LMJ_T8Dx3We7R1H9r9dG_9P5z4Bi6JclA</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Lass, Jonathan H</creator><creator>Benetz, Beth Ann</creator><creator>Gal, Robin L</creator><creator>Kollman, Craig</creator><creator>Raghinaru, Dan</creator><creator>Dontchev, Mariya</creator><creator>Mannis, Mark J</creator><creator>Holland, Edward J</creator><creator>Chow, Christopher</creator><creator>McCoy, Kristen</creator><creator>Price, Jr, Francis W</creator><creator>Sugar, Alan</creator><creator>Verdier, David D</creator><creator>Beck, Roy W</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Donor age and factors related to endothelial cell loss 10 years after penetrating keratoplasty: Specular Microscopy Ancillary Study</title><author>Lass, Jonathan H ; Benetz, Beth Ann ; Gal, Robin L ; Kollman, Craig ; Raghinaru, Dan ; Dontchev, Mariya ; Mannis, Mark J ; Holland, Edward J ; Chow, Christopher ; McCoy, Kristen ; Price, Jr, Francis W ; Sugar, Alan ; Verdier, David D ; Beck, Roy W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-44a1387c4f2d3ac88960dfc3a6e97cfd827bd458c610156a8b50cbf3f1a97e843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aging - pathology</topic><topic>Cell Count</topic><topic>Child</topic><topic>Corneal Edema - physiopathology</topic><topic>Corneal Edema - surgery</topic><topic>Corneal Endothelial Cell Loss - diagnosis</topic><topic>Corneal Endothelial Cell Loss - etiology</topic><topic>Corneal Endothelial Cell Loss - physiopathology</topic><topic>Double-Blind Method</topic><topic>Endothelium, Corneal - pathology</topic><topic>Eye Banks</topic><topic>Female</topic><topic>Fuchs' Endothelial Dystrophy - physiopathology</topic><topic>Fuchs' Endothelial Dystrophy - surgery</topic><topic>Graft Survival - physiology</topic><topic>Humans</topic><topic>Keratoplasty, Penetrating</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Tissue Donors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lass, Jonathan H</creatorcontrib><creatorcontrib>Benetz, Beth Ann</creatorcontrib><creatorcontrib>Gal, Robin L</creatorcontrib><creatorcontrib>Kollman, Craig</creatorcontrib><creatorcontrib>Raghinaru, Dan</creatorcontrib><creatorcontrib>Dontchev, Mariya</creatorcontrib><creatorcontrib>Mannis, Mark J</creatorcontrib><creatorcontrib>Holland, Edward J</creatorcontrib><creatorcontrib>Chow, Christopher</creatorcontrib><creatorcontrib>McCoy, Kristen</creatorcontrib><creatorcontrib>Price, Jr, Francis W</creatorcontrib><creatorcontrib>Sugar, Alan</creatorcontrib><creatorcontrib>Verdier, David D</creatorcontrib><creatorcontrib>Beck, Roy W</creatorcontrib><creatorcontrib>Writing Committee for the Cornea Donor Study Research Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Ophthalmology (Rochester, Minn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lass, Jonathan H</au><au>Benetz, Beth Ann</au><au>Gal, Robin L</au><au>Kollman, Craig</au><au>Raghinaru, Dan</au><au>Dontchev, Mariya</au><au>Mannis, Mark J</au><au>Holland, Edward J</au><au>Chow, Christopher</au><au>McCoy, Kristen</au><au>Price, Jr, Francis W</au><au>Sugar, Alan</au><au>Verdier, David D</au><au>Beck, Roy W</au><aucorp>Writing Committee for the Cornea Donor Study Research Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Donor age and factors related to endothelial cell loss 10 years after penetrating keratoplasty: Specular Microscopy Ancillary Study</atitle><jtitle>Ophthalmology (Rochester, Minn.)</jtitle><addtitle>Ophthalmology</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>120</volume><issue>12</issue><spage>2428</spage><epage>2435</epage><pages>2428-2435</pages><eissn>1549-4713</eissn><abstract>To examine the effect of donor age and other perioperative factors on long-term endothelial cell loss after penetrating keratoplasty (PKP).
Multicenter, prospective, double-masked clinical trial.
We included 176 participants from the Cornea Donor Study cohort who had not experienced graft failure ≥ 10 years after PKP for a moderate risk condition (principally Fuchs' dystrophy or pseudophakic/aphakic corneal edema).
Corneas from donors 12 to 75 years old were assigned to participants using a randomized approach, without respect to recipient factors. Surgery and postoperative care were performed according to the surgeons' usual routines. Images of the central endothelium were obtained preoperatively and at intervals for 10 years postoperatively. Images were analyzed by a central image analysis reading center to determine endothelial cell density (ECD).
Endothelial cell density at 10 years.
Among study participants with a clear graft at 10 years, the 125 who received a cornea from a donor 12 to 65 years old experienced a median cell loss of 76%, resulting in a 10-year median ECD of 628 cells/mm(2) (interquartile range [IQR], 522-850 cells/mm(2)), whereas the 51 who received a cornea from a donor 66 to 75 years old experienced a cell loss of 79%, resulting in a median 10-year ECD of 550 cells/mm(2) (IQR, 483-694 cells/mm(2); P adjusted for baseline ECD = 0.03). In addition to younger donor age, higher ECD values were significantly associated with higher baseline ECD (P<0.001) and larger donor tissue size (P<0.001). Forty-two of the 176 participants (24%) had an ECD of <500 cells/mm(2) at 10 years and only 24 (14%) had an ECD of >1000 cells/mm(2).
Substantial cell loss occurs in eyes with a clear graft 10 years after PKP, with the rate of cell loss being slightly greater with older donor age. Greater preoperative ECD and larger donor tissue size are associated with higher ECD at 10 years.</abstract><cop>United States</cop><pmid>24246826</pmid><doi>10.1016/j.ophtha.2013.08.044</doi><tpages>8</tpages></addata></record> |
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source | MEDLINE; Elsevier ScienceDirect Journals |
subjects | Adolescent Adult Aged Aging - pathology Cell Count Child Corneal Edema - physiopathology Corneal Edema - surgery Corneal Endothelial Cell Loss - diagnosis Corneal Endothelial Cell Loss - etiology Corneal Endothelial Cell Loss - physiopathology Double-Blind Method Endothelium, Corneal - pathology Eye Banks Female Fuchs' Endothelial Dystrophy - physiopathology Fuchs' Endothelial Dystrophy - surgery Graft Survival - physiology Humans Keratoplasty, Penetrating Male Middle Aged Postoperative Complications Prospective Studies Risk Factors Time Factors Tissue Donors Young Adult |
title | Donor age and factors related to endothelial cell loss 10 years after penetrating keratoplasty: Specular Microscopy Ancillary Study |
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