Endothelial cell loss and graft survival after penetrating keratoplasty for laser iridotomy-induced bullous keratopathy

Jpn J Ophthalmol. 2018 Jul;62(4):438-442. doi: 10.1007/s10384-018-0598-1. Epub 2018 May 15.


Purpose: To assess corneal endothelial cell loss after penetrating keratoplasty (PK) treatment for laser iridotomy (LI)-induced bullous keratopathy (BK).

Methods: A retrospective study conducted on consecutive patients who underwent PK between March 2000 and December 2011. Patients who had undergone more than 24 months of follow-up were included. Patients who underwent PK were subcategorized into two groups based on their diagnosis of BK prior to PK; PK was performed to treat either LI-BK or non LI-BK. The cell density of the central corneal endothelium and the graft survival were evaluated during follow-up.

Results: Corneal endothelial cell density decreased in a similar fashion in both the LI-BK and non LI-BK patients, though the cell density decreased significantly faster in the LI-BK group than in the non LI-BK group throughout the 108 months of the study (p = 0.026). The mean cell loss at 36 months for the LI-BK group was 57.7% vs. 63.2% for the non LI-BK, 76.9% vs. 70.1% at 72 months, and 85.6% vs. 72.0% at 108 months. No eye among 21 eyes in the LI-BK group (0%) had failed grafts, whereas 4 of 25 eyes in the non LI-BK group (16.0%) had failed grafts at 60 months (p = 0.114).

Conclusions: The outcome of PK for BK secondary to LI was no worse than the outcome of PK for other types of BK. However, our long-term follow-up after PK showed that cell density decreased faster in the LI-BK group than in the non LI-BK, suggesting that cell loss might be involved in the existence of LI prior to PK.

Keywords: Corneal endothelial cell density; Penetrating keratoplasty; Trabeculectomy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cell Count
  • Corneal Diseases / etiology
  • Corneal Diseases / surgery
  • Corneal Endothelial Cell Loss / etiology*
  • Endothelium, Corneal / pathology*
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Iris / surgery*
  • Keratoplasty, Penetrating / adverse effects*
  • Laser Therapy / adverse effects*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Visual Acuity
  • Young Adult