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Autologous grafts show lower endothelial cell loss than homologous grafts
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Endothelial cell loss in autologous corneal grafts was “significantly lower” than in homologous grafts, according to a study in Germany. The study authors said autologous grafts — specifically rotational keratoplasty — can lead to good functional results, superior to homologous grafts, in suitable cases.
Eckart Bertelmann, MD, and colleagues at Humboldt University in Berlin compared seven patients who underwent rotational keratoplasty between 1998 and 2000 to a large group of patients who underwent homologous keratoplasty. Follow-up for the autologous graft patients was every 3 months, with a mean total follow-up of 39 months. Visual acuity, astigmatism and endothelial cell density were evaluated, and endothelial cell counts were compared to those in 293 homologous keratoplasties.
The mean increase in VA was 3.5 lines. The mean preoperative endothelial cell density was 2,058; after 1 year mean endothelial cell density was 1,865, representing a 15% cell loss in those undergoing autologous grafts. After 1 year in the group with homologous grafts, the endothelial cell loss was 40%.
The researchers said their findings support the hypothesis that chronic endothelial cell loss is due to chronic subclinical immune reactions in homologous grafts.
The study is published in the October issue of Archives of Ophthalmology.