Endothelial cell density after posterior lamellar keratoplasty (Melles techniques): 3 years follow-up

PURPOSE: To report the midterm endothelial cell density measurements after posterior lamellar keratoplasty (Melles techniques).

DESIGN: Cohort study.

METHODS: Fifteen consecutive eyes of 15 patients in whom a posterior lamellar keratoplasty procedure was performed for pseudophakic bullous keratopathy or Fuchs' endothelial dystrophy were evaluated. In 11 corneas the donor tissue was inserted through a 9.0-mm sclerocorneal pocket incision (technique A); in four cases the donor was folded and inserted through a 5.0-mm incision (technique B). Specular microscopy was performed at 6, 12, 24, and 36 months after surgery, to measure the endothelial cell density.

RESULTS: Mean postoperative endothelial cell density averaged 2,126 cells/mm(2) (+/-548) at 6 months, 1,859 cells/mm(2) (+/-477) at 12 months, 1,385 cells/mm(2) (+/-451) at 24 months, and 1,047 cells/mm(2) (+/-425) at 36 months.

CONCLUSION: In posterior lamellar keratoplasty, the donor corneal endothelium showed a decrease in cell density similar to that after conventional full-thickness penetrating keratoplasty.