Abstract：
OBJECTIVE: 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.
METHODS: 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.
METHODS: 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.
摘要：
目的：根据供体角膜内皮细胞的成熟度，通过角膜内皮细胞密度（ECD）和角膜内皮细胞丢失（ECL），在有或没有青光眼手术史的患者移植后5年检查角膜移植物的存活率。
方法：前瞻性队列研究。
方法：这项前瞻性队列研究涉及17名青光眼患者和51名非青光眼患者，他们在浸信会眼科研究所接受了Descemet剥离自动内皮角膜移植术或穿透性角膜移植术，京都,2014年10月至2016年10月期间的日本。从残留的外周供体角膜组织中培养人角膜内皮细胞，并通过细胞表面标记物评估细胞的成熟度（即，CD166+,CD44-/暗淡，CD24-,和CD105-）使用荧光激活的细胞分选。使用Kaplan-Meier分析或卡方检验来评估移植后成功的角膜移植物存活率。
结果：术后36个月，平均ECD和平均ECL，分别,青光眼泡眼中,高成熟度组为1197±352个细胞/mm2,高成熟度组为55.5±13.9%,低成熟度组为853±430个细胞/mm2,低成熟度组为67.7±18.1%.Kaplan-Meier分析显示，术后5年，总生存率为45%；即，高成熟度组100％，低成熟度组25％（P<0.05）。
结论：这项前瞻性队列研究的结果表明，使用含有成熟分化角膜内皮细胞的供体角膜移植物可以长期维持移植移植物的存活，即使是有青光眼手术史的患者。
方法：前瞻性队列研究。
方法：这项前瞻性队列研究涉及17名青光眼患者和51名非青光眼患者，他们在浸信会眼科研究所接受了Descemet剥离自动内皮角膜移植术或穿透性角膜移植术，京都,2014年10月至2016年10月期间的日本。从残留的外周供体角膜组织中培养人角膜内皮细胞，并通过细胞表面标记物评估细胞的成熟度（即，CD166+,CD44-/暗淡，CD24-,和CD105-）使用荧光激活的细胞分选。使用Kaplan-Meier分析或卡方检验来评估移植后成功的角膜移植物存活率。
结果：术后36个月，平均ECD和平均ECL，分别,青光眼泡眼中,高成熟度组为1197±352个细胞/mm2,高成熟度组为55.5±13.9%,低成熟度组为853±430个细胞/mm2,低成熟度组为67.7±18.1%.Kaplan-Meier分析显示，术后5年，总生存率为45%；即，高成熟度组100％，低成熟度组25％（P<0.05）。
结论：这项前瞻性队列研究的结果表明，使用含有成熟分化角膜内皮细胞的供体角膜移植物可以长期维持移植移植物的存活，即使是有青光眼手术史的患者。
