Association Between Intracellular Dark Spots on Specular Microscopy and Endothelial Cell Loss After Penetrating Keratoplasty

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-08-19 DOI:10.1016/j.ajo.2025.08.022

TAKAHIRO KANDA , OSAMA M.A. IBRAHIM , YURINA MORI-OGIWARA , YUKARI YAGI-YAGUCHI , KAZUNARI HIGA , HIROTSUGU KASAMATSU , TAIYO SHIJO , DAISUKE TOMIDA , HISASHI NOMA , SHINSUKE SHIBATA , MURAT DOGRU , TAKEFUMI YAMAGUCHI

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引用次数: 0

Abstract

Purpose

To investigate the incidence and clinical implications of intracellular dark endothelial spots (IDES) following penetrating keratoplasty (PK) and their association with endothelial cell density (ECD) loss and graft failure.

Design

Retrospective clinical cohort study.

Methods

This study included 71 eyes that underwent PK and 33 control eyes that underwent cataract surgery. We evaluated the presence of IDES on specular microscopy, ECD, preoperative aqueous humor (AqH) protein and cytokine levels using Luminex. Follow-up examinations were conducted for 36 months postoperatively. Logistic regression analysis was performed to identify clinical risk factors for IDES development and graft survival.

Results

IDES developed in 40 PK eyes (56.3%). IDES was associated with exhibiting significantly lower ECD at all postoperative stages (P < .001) and higher secondary graft failure rates compared to IDES-negative eyes (P = .014). Risk factors for IDES development after PK included the presence of an intraocular lens (P = .028), multiple previous intraocular surgeries (P = .0076), and lower preoperative donor ECD (P = .004). IDES-positive eyes with an ECD decrease of more than 50% within 12 months postoperatively had significantly higher preoperative AqH protein levels compared to those without such a decrease (P = .031). Kaplan-Meier analysis showed a higher rate of graft failure in IDES-positive eyes compared to those without (P = .014).

Conclusions

The development of IDES after PK appears to be associated with higher ECD loss and graft failure, suggesting its potential as a biomarker for endothelial cell loss and graft prognosis.

查看原文本刊更多论文

穿透性角膜移植术后细胞内黑斑与内皮细胞损失的关系。

目的：探讨穿透性角膜移植术（PK）后细胞内暗内皮斑（IDES）的发生率和临床意义，以及它们与内皮细胞密度（ECD）下降和移植失败的关系。设计：回顾性临床队列研究。方法：本研究纳入71只行PK的眼和33只行白内障手术的对照眼。我们使用Luminex通过镜面显微镜、ECD、术前房水（AqH）蛋白和细胞因子水平评估IDES的存在。术后随访36个月。进行Logistic回归分析以确定IDES发展和移植物存活的临床危险因素。结果：40只PK眼发生IDES（56.3%）。结论：PK后发生IDES与较高的ECD损失和移植物衰竭有关，这表明IDES有可能作为内皮细胞损失和移植物预后的生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.