Endothelial Cell Loss Rate Following Penetrating Keratoplasty: Optical versus Therapeutic Grafts

Abstract Purpose: To compare the rate of endothelial cell loss (ECL) following penetrating keratoplasty (PKP) for optical and therapeutic indications and to state whether therapeutic PKP is inferior to optical PKP or not.Methods: This is a Prospective, observational, comparative study that included patients who sought medical advice at the Cornea Outpatient Clinic of Ain Shams University Hospitals. The study enrolled two groups; group 1 included 30 corneas of 30 patients who performed optical PKP for various purposes, while group 2 comprised 30 corneas of 30 patients who were planned for performing therapeutic PKP for unhealed, resistant corneal infections. Specular microscopy was done to all the patients at the 3-, 6- and 12-months visits using Nidek CEM-530 (NIDEK Co., Ltd. Japan) specular microscope. Results: There were no statistically significant differences between both groups as regards to the timing of the graft clarity following surgery or the rate of ECL at the 3- and 6- months intervals, yet the rate of ECL was significantly higher in group 2 compared to group 1 at the 12 months interval (P-value <0.05), though the statistical difference was narrow from a clinical point of view. There was also no statistically significant difference between both groups regarding the rate of graft rejection.Conclusion: Therapeutic PKP can be considered non-inferior to optical PKP regarding the graft viability, the rate of ECL, and the rate of graft rejection along a follow up interval of one year.