Corneal endothelium and potoperative outcome 15 year after penetrating keratoplaty

Purpoe To determine change in the central endothelium and thickne of grafted cornea and the cumulative probability of developing glaucoma, of graft rejection, and of graft failure 15 year after penetrating keratoplaty. Deign Longitudinal cohort tudy of 500 conecutive penetrating keratoplatie by one urgeon. Method Regrafted eye, fellow eye of bilateral cae, and patient not granting reearch authorization were excluded, leaving 388 graft for analyi. At interval after urgery, we photographed the endothelium and meaured corneal thickne uing pecular microcopy. The preence of glaucoma, graft rejection, and graft failure were recorded. Reult The 67 patient examined at 15 year repreented 30% of the available clear graft. Endothelial cell lo from preoperative donor level wa 71 ± 12% (mean ± tandard deviation, n = 67), endothelial cell denity wa 872 ± 348 cell/mm2, and corneal thickne wa 0.59 ± 0.06 mm. Endothelial cell denity wa unchanged between 10 and 15 year, wherea corneal thickne increaed (P = .001, n = 55). The mean annual rate of endothelial cell lo from 10 to 15 year after urgery wa 0.2 ± 5.7% (n = 54). The cumulative probability of developing glaucoma, graft rejection, or graft failure wa 20%, 23%, and 28%, repectively, and 6 of the 8 graft failure after 10 year reulted from late endothelial failure. Concluion From 10 to 15 year after penetrating keratoplaty, the annual rate of endothelial cell lo wa imilar to that of normal cornea, corneal thickne increaed, and late endothelial failure wa the major caue of graft failure.