Postoperative Endothelial Cell Density Is Associated with Late Endothelial Graft Failure after Descemet Stripping Automated Endothelial Keratoplasty.
作者： Sanjay V. Patel , Jonathan H Lass , Beth Ann Benetz , Loretta B Szczotka-Flynn , Nathan J Cohen
DOI: 10.1016/J.OPHTHA.2019.02.011
关键词: Medicine 、 Proportional hazards model 、 Ophthalmology 、 Cornea 、 Confidence interval 、 Dystrophy 、 Cohort study 、 Randomized controlled trial 、 Endothelium 、 Interquartile range
摘要: Purpose To determine whether preoperative endothelial cell density (ECD) and postoperative ECD after Descemet stripping automated keratoplasty (DSAEK) are associated with late graft failure (LEGF) in the Cornea Preservation Time Study (CPTS). Design Cohort study within a multicenter, randomized clinical trial. Participants A total of 1007 individuals (1223 eyes), mean age 70 years, undergoing DSAEK for Fuchs’ dystrophy (94% eyes) or pseudophakic aphakic corneal edema (PACE) (6% followed up to 5 years. Methods Central was determined by central image analysis reading center. Preoperative 1209 eyes that did not fail 14 experienced LEGF. The at 6 12 months DSAEK, change from months, surgeon-reported operative complications, dislocation were investigated an association LEGFs unrelated other events. Univariable multivariable Cox proportional hazards regression models used assess associations. Main Outcome Measures Late its associations pre- complications. Results cumulative probability LEGF 1.3% (95% confidence interval [CI], 0.8%–2.4%). Median (interquartile range [IQR]) ECDs similar (2523; 2367–3161) cells/mm2) without (2727; 2508–2973) (P = 0.34). (P Conclusions In is LEGF, whereas lower Early loss intraoperative complications should be minimized improve survival.
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