Abstract

Endothelia of 102 clear human corneal grafts in 95 patients were photographed in vivo with a specular microscope. The relation of the endothelial cell density to the HLA and ABO compatibility of the donor‐recipient pairs were studied. In addition, the effects of vascularization and reversible rejection on the endothelial cell density were analysed.A negative correlation was found between the HLA incompatibility and the endothelial cell density of the graft. The group with 0–1 (2) mismatches had the highest endothelial cell density (1356 ± 510 cells/mm2). This result was better than in the group with 2 (3) mismatches, but the cell difference was not statistically significant. A statistically significant difference in average endothelial cell densities was found between the groups with 0–1 (2) mismatches and with 3–4 mismatches, the latter having 880 ± 475 cells/mm2 (P < 0.01). There was also a statistically significant difference in average endothelial cell densities between the group with 0–1 mismatch and the untyped group (P < 0.01). The difference in cell densities between the group with 2 (3) mismatches and the more incompatible groups together (3–4 mismatches and the untyped group) was statistically almost significant (P < 0.05).The ABO‐compatible pairs had 18% more endothelial cells than the ABO‐incompatible pairs. The difference was not statistically significant, but when the ABO‐compatible pairs were compared with all the others (incompatible and untyped), the difference in mean cell density between the two groups was statistically almost significant (P < 0.05).Comparison of the effect of tissue incompatibility on graft endothelial cell density separately in the patients with vascularized and non‐vascularized corneas showed that in both categories the endothelial cell density was highest in the group with 0–1 (2) mismatches.In 8 patients with a reversible rejection episode the average cell density was 20% less than in those with an uneventful postoperative period. The importance of rejection on the endothelium in some special cases is discussed.

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