Dados do Trabalho

Título

ENDOTHELIAL FINDINGS IN THE DONOR DISC AND RECEPTOR RING IN PATIENTS WITH PENETRANT KERATOPLASTY

Fundamentação/Introdução

Introduction: The donated corneas used in Penetrant Keratoplasty (PK) lose approximately 50% of endothelial density in the first 5 years, after the endothelial cell (EC) loss decline. Considering specular microscopy exams, there is no report in the literature on the behavior of the endothelial mosaic (EM) cells on the receptor disc of patients with PK by keratoconus (KC) in which EC is normal.

Objetivos

Purpose: To know the profile of the endothelium of transplanted corneas more than 5 years, comparing the EM cells of the donated corneas with the EM cells of the recipient corneal ring.

Delineamento e Métodos

Methods: Cross-sectional study of 24 eyes more than 5 years after PK – Corneal Endothelium Lab DANAT UFPR. The sampling error (Reliability Degree 95% and Relative Error < 0.05) of each Corneal Specular Microscopy (CSM) as well as the number of EM images included in the exam in each of these two sectors, Donor Disc and Recipient Ring, was determined by the software Cells Analyzer (Patent USA). Contact BioOptics 2500 Bambi CSM (BioOptics, USA) to evaluate the endothelial mosaic (EM) at the Donor Disc (DD Group) and the Recipient Ring (RR Group) comparing Endothelial Cell Density (ECD), Coefficient of Variation (CV), and hexagonal cells (% HEX). Comparisons of DD Group with RR Group: The t Student test was used at p<0.05. Statistical software Core Team 3.6.3..

Resultados

Results:

Age 32 - 69 years old, average 44,1±8,7 years old.

The time between PK - CSM is 5 -29 years, average of 12,8±6,9 years.

Number of EM images per exam: DD Group 3 - 17, average 9,1±3,3 and RR Group 1 – 5, average 2,4±1,2.

RR ECD: 531 – 1626 cells/mm2., average 921±287 cells/mm2.; DD ECD: 547 – 1319 cells/mm2, average 829±189 cells/mm2.; p>0.05.

RR CV: 0.23 – 0.45, average 0.32±0.06; DD CV: 0.20 – 0.46, average 0.33±0.06; p>0.05

%HEX: 36 – 67, average 53±8,8; %HEX: 42 - 64, average 51±6,6; p>0.05.

Conclusões/Considerações Finais

Conclusions: There is no difference in EM between RR and DD in patients with more than 5 years of PK. The endothelial mosaic of keratoconus was normal in the peripheral area after PK, these results suggested that the high cell loss of RR. This cell loss must be related to the canyon effect caused by the EM unevenness of the scar between the surfaces of the RR and DD.

Palavras-chave

Corneal endothelium, Penetrant Keratoplasty, Transplanted Corneas, Corneal Specular Microscopy.