Intracellular dark spots are associated with endothelial cell loss after Descemet’s stripping automated endothelial keratoplasty
Yurina Mori-Ogiwara, Yukari Yagi-Yaguchi, Osama Mohamed Ibrahim, Kazunari Higa, Hirotsugu Kasamatsu, Takahiro Kanda, Daisuke Tomida, Yoshinori Oie, Takahiko Hayashi, Jun Shimazaki, Takefumi Yamaguchi
Abstract
Intracellular dark endothelial spots (IDESs) on specular microscopy developed in 78/122 patients (63.9%) after Descemet stripping automated endothelial keratoplasty (DSAEK). Endothelial cell density (ECD) after DSAEK was significantly smaller in eyes with IDES when compared with those without at all time points (p<0.001) despite no significant difference in graft ECD (p=0.43), resulting in an increased rate of endothelial failure (p=0.044). The presence of glaucoma (OR=2.22, p=0.027), iris damage (OR=2.85, p=0.004) and non-Fuchs status (OR=2.37, p=0.018) were identified as risk factors for IDES development. Preoperative total protein level in aqueous humour was significantly higher in eye with endothelial failure than those without (p=0.0057).