전층 각막이식술 후 장기간 경과 시 각막내피세포 생존에 영향을 주는 요인 분석

Analysis of Factors Affecting Corneal Endothelial Cell Loss after Penetrating Keratoplasty

Purpose: To evaluate the factors affecting corneal endothelial cell loss after penetrating keratoplasty in a long-term follow- up. Methods: Donor age, post-mortem time, storage time, underlying disease, elevation of IOP after surgery, underlying glaucoma, and trephine size were analyzed in 76 eyes. Postoperative corneal endothelial density was measured after 1, 3, 6, and 12 months. Patients who experienced graft rejection were excluded. Results: Donor age and endothelial loss were correlated in all patients (t-value = 1.98); however, post-mortem time and storage time were not statistically significant (t < 2). Endothelial cell loss was more severe in the bullous keratopathy patient group than it was in the keratoconus patient group, but this difference was not statistically significant (p-value = 0.154). The number of anti-glaucomatous eye drops showed positive correlation with the declining rate of endothelial cells (t-value = 1.975). Existence of glaucoma diagnosed before surgery did not statistically influence endothelial cell loss. Additionally, in the bullous keratopathy patient group, an inverse correlation between endothelial cell loss and trephine diameter was observed (t-value = -2.859). Conclusions: Old donor age, small trephine size in bullous keratopathy, and post-operative IOP elevation are risk factors for increased endothelial cell loss following penetrating keratoplasty. J Korean Ophthalmol Soc 2011;52(7):807-815