Klinische Monatsblatter fur Augenheilkunde | 2021
Endothelial Cell Density and Central Corneal Thickness following Penetrating Keratoplasty of Acanthamoeba Keratitis Patients - A Retrospective Cross-Sectional Observational Study.
Abstract
PURPOSE\nTo analyze endothelial cell density (ECD) and central corneal thickness (CCT) following penetrating keratoplasty (PKP) in Acanthamoeba keratitis (AK) patients.\n\n\nPATIENTS AND METHODS\nIn this retrospective, clinical, single-center, cross-sectional, observational study, patients were enrolled who underwent PKP at the Department of Ophthalmology of Saarland University Medical Center, Homburg/Saar, Germany between May 2008 and December 2016 with the diagnosis of AK. In all, 33 eyes of 33 patients (14 males, 42%) were enrolled; their mean age at the time of surgery was 39.5\u2009±\u200914.3 years. Postoperatively, AK patients received topical polyhexamethylene biguanide, propamidine isethionate, neomycin sulphate/gramicidin/polymixin B sulfate, and prednisolone acetate eye drops (5\u2009×/day each), and the topical treatment was tapered sequentially with 1 drop every 6 weeks over 6 months. CCT was recorded using Pentacam HR Scheimpflug tomography and ECD with the EM-3000 specular microscope before surgery and 3 and 6 months after surgery as well as after the first and second (complete) suture removal.\n\n\nRESULTS\nECD tended to decrease significantly from the time point before surgery (2232\u2009±\u2009296 cells/mm2) to the time point 3 months after surgery (1914\u2009±\u2009164 cells/mm2; p\u2009=\u20090.080) and to the time point after the first suture removal (1886\u2009±\u2009557 cells/mm2; p\u2009=\u20090.066) and decrease significantly to the time point after the second suture removal (1650\u2009±\u2009446 cells/mm2; p\u2009=\u20090.028). CCT did not change significantly over the analyzed time period (p\u2009≥\u20090.475).\n\n\nCONCLUSION\nIn AK, endothelial cell loss does not seem to be accelerated following PKP, despite the postoperative use of diamidine and biguanide. A subsequent prospective comparative study should confirm our retrospective longitudinal analysis.