Endothelium and pachymetry of clear corneal grafts 15 to 33 years after penetrating keratoplasty

PURPOSE: To evaluate long-term endothelial cell count and thickness of clea r corneal grafts after penetrating keratoplasty. METHODS: Specular microscopy and ultrasonic pachymetry were performed in 20 eyes (14 eyes that were keratoconus, three aphakic/pseudophakic bullous ke ratopathy, one Fuchs dystrophy, one had herpetic keratitis, and one avascul ar scar after injury) of 18 patients (mean age +/- SD 58 +/- 15 years; rang e, 34 to 82 years) with a mean follow-up of 22 +/- 6 years (range, 15 to 33 years), RESULTS: Mean endothelial cell count was 808 +/- 194 cells per mm(2) (range , 575 to 1243 cells/mm(2)), and thickness was 608 +/- 75 mu m (range, 430 t o 751 mu m) Endothelial cell count was neither correlated with thickness (P =.25, r(2) =.08) nor with follow up interval (P =.31, r(2) =.028), We obse rved predominantly enlarged endothelial cells and mild polymegethism, No gr aft rejections were recorded. CONCLUSION: Despite a reduced cell density, the dehydration function of the endothelium may still be sufficient in corneal grafts up to 33 years after penetrating keratoplasty. (C) 1999 by Elsevier Science Inc. All rights res erved.