Endothelial cell count in the host corneal endothelium. Situation after block excision and peripheral tectonic corneoscleral grafting

Purpose. Block excision of anterior uveal tumors and cystic epithelial ingr owth to the anterior chamber is a curative treatment for morphological reha bilitation of the globe. This study quantified the course of the host corne al endothelium after this peripheral corneoscleral graft. Patients and methods. This retrospective cross-sectional study examined 53 specular microscopic photographs of the central host cornea in 30 patients. The diameter of the block excision was 8.5+/-1.9 mm (6.0-11.0 mm). Follow- up after surgery averaged 37.9+/-47.6 months (1-216). Results. The corneal endothelial cell count decreased with the duration of follow-up after block excision. The cell count was not related to indication for surgery or to d iameter of block excision. Mean visual acuity was 16/20 before block excisi on and 6/20 at the end of follow-up. Conclusion. There is a significant loss of endothelial cells of the host af ter block excision, requiring a second central penetrating keratoplasty in some patients. Loss of endothelial cells may be due to the surgical trauma, chronic immunological reaction against the donor endothelium, or migration of the host endothelial cells onto the corneoscleral graft.