Endothelial cell density after posterior lamellar keratoplasty (Melles techniques): 3 years follow-up

Abstract

Purpose To report the midterm endothelial cell density measurements after posterior lamellar keratoplasty (Melles techniques). Design Cohort study. Methods Fifteen consecutive eyes of 15 patients in whom a posterior lamellar keratoplasty procedure was performed for pseudophakic bullous keratopathy or Fuchs' endothelial dystrophy were evaluated. In 11 corneas the donor tissue was inserted through a 9.0-mm sclerocorneal pocket incision (technique A); in four cases the donor was folded and inserted through a 5.0-mm incision (technique B). Specular microscopy was performed at 6, 12, 24, and 36 months after surgery, to measure the endothelial cell density. Results Mean postoperative endothelial cell density averaged 2,126 cells/mm 2 (±548) at 6 months, 1,859 cells/mm 2 (±477) at 12 months, 1,385 cells/mm 2 (±451) at 24 months, and 1,047 cells/mm 2 (±425) at 36 months. Conclusion In posterior lamellar keratoplasty, the donor corneal endothelium showed a decrease in cell density similar to that after conventional full-thickness penetrating keratoplasty.