Donor Corneal Endothelial Cell Maturity and Its Impact on Graft Survival in Glaucoma Patients Undergoing Corneal Transplantation

Koji Kitazawa; Munetoyo Toda; Morio Ueno; Koichi Wakimasu; Yasufumi Tomioka; Asako Uehara; Chie Sotozono; Shigeru Kinoshita

doi:10.1016/j.ajo.2024.01.033

Donor Corneal Endothelial Cell Maturity and Its Impact on Graft Survival in Glaucoma Patients Undergoing Corneal Transplantation

Am J Ophthalmol. 2024 Feb 1:262:1-9. doi: 10.1016/j.ajo.2024.01.033. Online ahead of print.

Authors

Koji Kitazawa¹, Munetoyo Toda², Morio Ueno³, Koichi Wakimasu⁴, Yasufumi Tomioka³, Asako Uehara³, Chie Sotozono¹, Shigeru Kinoshita⁵

Affiliations

¹ From the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan (K.K., M.T., M.U., Y.T., A.U., C.S.); Department of Ophthalmology, Baptist Eye Institute, Kyoto, Japan (K.K., K.W., C.S., S.K.).
² From the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan (K.K., M.T., M.U., Y.T., A.U., C.S.); Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan (M.T., S.K.).
³ From the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan (K.K., M.T., M.U., Y.T., A.U., C.S.).
⁴ Department of Ophthalmology, Baptist Eye Institute, Kyoto, Japan (K.K., K.W., C.S., S.K.).
⁵ Department of Ophthalmology, Baptist Eye Institute, Kyoto, Japan (K.K., K.W., C.S., S.K.); Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan (M.T., S.K.). Electronic address: shigeruk@koto.kpu-m.ac.jp.

PMID: 38307212
DOI: 10.1016/j.ajo.2024.01.033

Abstract

Purpose: To examine corneal graft survival via corneal endothelial cell density (ECD) and corneal endothelial cell loss (ECL) at 5 years post-transplantation in the eyes of patients with and without a history of undergoing glaucoma surgery according to the maturity of the donor corneal endothelial cells.

Design: Prospective cohort study.

Methods: This prospective cohort study included 17 patients with glaucoma and 51 patients without glaucoma who underwent Descemet's stripping automated endothelial keratoplasty or penetrating keratoplasty at the Baptist Eye Institute, Kyoto, Japan, between October 2014 and October 2016. Human corneal endothelial cells were cultured from residual peripheral donor cornea tissue, and the maturity of the cells was evaluated by cell surface markers (ie, CD166⁺, CD44^-/dull, CD24^-, and CD105^-) using fluorescence-activated cell sorting. Kaplan-Meier analysis or the chi-square test was used to assess the rate of successful corneal graft survival post-transplantation.

Results: At 36 months postoperatively, the mean ECD and ECL in the glaucoma-bleb eyes were 1197 ± 352 cells/mm² and 55.5% ± 13.9% in the high-maturity group and 853 ± 430 cells/mm² and 67.7% ± 18.1% in the low-maturity group, respectively. Kaplan-Meier analysis revealed that at 5 years postoperatively, the overall rate of survival was 45%, that is, 100% in the high-maturity group and 25% in the low-maturity group (P < .05).

Conclusions: The findings in this prospective cohort study revealed that the use of donor corneal grafts containing mature-differentiated corneal endothelial cells could maintain the survival of the transplanted graft for a long-term period, even in patients with a history of undergoing glaucoma surgery.