Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Corneal Endothelial Cell Loss After Phacoemulsification in Post-Penetrating Keratoplasty Eyes with Domestic andImported Donor Cornea: Cross-Sectional Research
Yerli ve İthal Donör Kornealı Penetran Keratoplasti Yapılan Gözlerde Fakoemülsifikasyon Sonrası Kornea Endotel Hücre Kaybı: Kesitsel Araştırma
Evin ŞİNGARa , Ayşe BURCUa , Züleyha YALNIZ AKKAYAa , Selma ÖZBEK UZMANa , Barış ORALb
aDepartment of Ophthalmology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Türkiye
bClinic of Ophthalmology, Gebze Hospital, Kocaeli, Türkiye
Turkiye Klinikleri J Ophthalmol. 2023;32(4):203-9
doi: 10.5336/ophthal.2022-94693
Article Language: EN
Full Text
ABSTRACT
 Objective: To compare the changes in endothelial cell density (ECD) in patients who underwent cataract extraction with phacoemulsification after penetrating keratoplasty (PK) with domestic and imported corneas. Material and Methods: Patients who had PK with domestic (Group 1) and imported (Group 2) donor corneas underwent phacoemulsification between April 2013 and June 2014 were included in this study. ECD was evaluated with noncontact specular microscopy before and 1st, 3rd, 6th, 12th months after cataract surgery. Results: In Group 1, 15 eyes of 15 patients and in Group 2, 13 eyes of 13 patients were evaluated. No significant differences were observed between the groups with respect to age, gender, laterality, indication for PK, nuclear opacity, time interval between PK and cataract surgery (p>0.05). The domestic group had a lower donor age (p=0.049), shorter preservationto-surgery times and more ECD (p<0.001). The mean corneal ECD was 2910.73±312.16 (2451-2454) cells/mm2 in Group 1 and 2463.54±236.99 (2043-2876) cells/mm2 in Group 2 preoperatively (p<0.001). ECD was significantly higher in domestic donor corneas compared to imported donor corneas before PK, before cataract surgery, and at all controls after cataract surgery (p<0.05, for each). The percentage of mean decrease in the number of ECD between postoperative 1st-3rd month, 3rd6th month and for the 6th-12th month was statistically higher in imported group than in the domestic group (p<0.05, for each). Conclusion: Related to the amount of change in ECD after cataract surgery, imported corneas seem as credible as domestic corneas. To reach the exact outcome, more detailed and longlasting studies are necessary.

Keywords: Penetrating keratoplasty; imported cornea; domestic cornea; donor cornea; eyebank
ÖZET
 Amaç: Yerli ve ithal kornealarla penetran keratoplasti (PK) sonrası fakoemülsifikasyon ile katarakt ekstraksiyonu yapılan hastalarda endotel hücre yoğunluğundaki [endothelial cell density (ECD)] değişiklikleri karşılaştırmak. Gereç ve Yöntemler: Bu çalışmaya Nisan 2013-Haziran 2014 tarihleri arasında yerli donör kornea (Grup 1) ve ithal donör kornea (Grup 2) ile PK sonrası fakoemülsifikasyon yöntemi ile katarakt cerrahisi olan hastalar dâhil edildi. ECD, katarakt cerrahisi öncesi ve sonrası 1, 3, 6, 12. aylarda temassız speküler mikroskopi ile değerlendirildi. Bulgular: Grup 1'de 15 hastanın 15 gözü ve Grup 2'de 13 hastanın 13 gözü değerlendirildi. Gruplar arasında yaş, cinsiyet, lateralite, PK endikasyonu, nükleer opasite ve PK ile katarakt cerrahisi arasındaki süre açısından anlamlı fark gözlenmedi (p>0,05). Yerli grubun donör yaşı daha düşük (p=0,049), ameliyata kadar geçen süre daha kısa ve daha fazla ECD (p<0,001) vardı. Ameliyat öncesi ortalama kornea ECD'si Grup 1'de 2910,73±312,16 (2451-2454) hücre/mm2 ve Grup 2'de 2463,54±236,99 (2043-2876) hücre/mm2 idi (p<0,001).ECD, PK öncesi, katarakt ameliyatı öncesi ve katarakt ameliyatı sonrası tüm kontrollerde ithal donör kornealara kıyasla yerli donör kornealarda önemli ölçüde daha yüksekti (p<0,05). ECD ortalama azalma yüzdesi, ameliyat sonrası 1-3. ay, 3-6. ay ve 6-12. ay arasında yerli gruba kıyasla ithal grupta grupta istatistiksel olarak daha fazla idi (her biri için p<0,05). Sonuç: Katarakt cerrahisi sonrası ECD'deki değişim miktarı ile ilgili olarak ithal kornealar yerli kornealar kadar güvenilir görünmektedir. Kesin sonuca ulaşmak için daha detaylı ve uzun süreli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Penetran keratoplasti; ithal kornea; yerli kornea; donör kornea; göz bankacılığı
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