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Kitazawa K, Toda M, Ueno M, Wakimasu K, Tomioka Y, Uehara A, Sotozono C, Kinoshita S. Donor Corneal Endothelial Cell Maturity and Its Impact on Graft Survival in Glaucoma Patients Undergoing Corneal Transplantation. Am J Ophthalmol 2024; 262:1-9. [PMID: 38307212 DOI: 10.1016/j.ajo.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 08/28/2023] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
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.
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Affiliation(s)
- Koji Kitazawa
- 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.)
| | - Munetoyo Toda
- 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.)
| | - Morio Ueno
- From the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan (K.K., M.T., M.U., Y.T., A.U., C.S.)
| | - Koichi Wakimasu
- Department of Ophthalmology, Baptist Eye Institute, Kyoto, Japan (K.K., K.W., C.S., S.K.)
| | - Yasufumi Tomioka
- From the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan (K.K., M.T., M.U., Y.T., A.U., C.S.)
| | - Asako Uehara
- From the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan (K.K., M.T., M.U., Y.T., A.U., C.S.)
| | - Chie Sotozono
- 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.)
| | - Shigeru Kinoshita
- 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.).
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UENO MORIO, TODA MUNETOYO, NUMA KOHSAKU, TANAKA HIROSHI, IMAI KOJIRO, BUSH JOHN, TERAMUKAI SATOSHI, OKUMURA NAOKI, KOIZUMI NORIKO, YAMAMOTO AKIHISA, TANAKA MOTOMU, SOTOZONO CHIE, HAMURO JUNJI, KINOSHITA SHIGERU. Superiority of Mature Differentiated Cultured Human Corneal Endothelial Cell Injection Therapy for Corneal Endothelial Failure. Am J Ophthalmol 2022; 237:267-277. [PMID: 34788595 DOI: 10.1016/j.ajo.2021.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the safety and efficacy of cultured human corneal endothelial cell (hCEC) injection therapy with mature differentiated (mature) cell subpopulations (SPs) for corneal endothelial failure (CEF). DESIGN Comparative, interventional case series. METHODS This study involved 18 eyes with CEF that underwent cultured hCEC injection therapy, categorized into 2 groups: (1) 11 eyes administered a relatively lower proportion (0.1 to 76.3%) of mature cell SPs (group 1 [Gr1]), and (2) 7 eyes administered a relatively higher proportion (>90%) of mature cell SPs (group 2 [Gr2]). From 1 week to 3 years postoperation, corneal endothelial cell (CEC) density (CECD), central corneal thickness (CCT), and best-corrected visual acuity (BCVA) were recorded, and the CEC parameter's "spring constant" was calculated. The proportion of mature SPs was evaluated by fluorescence-activated cell sorting analysis based on cell-surface markers. RESULTS At 3 years postoperation, corneal restoration with improved BCVA was attained in 10 of the 11 Gr1 eyes and all Gr2 eyes, the median CECD in Gr2 (3083 cells/mm2; range, 2182-4417 cells/mm2) was higher than that in Gr1 (1349 cells/mm2; range, 746-2104 cells/mm2) (P < .001), and the spring constant verified the superiority of the mature cultured hCECs. From 24 weeks through 3 years postoperation, the median percentage of CECD decrease was 3.2% in Gr2 and 23.6% in Gr1 (P < .005). CCT recovery was prompt and constant in Gr2, while diverse in Gr1. No adverse events were observed. CONCLUSION Our findings showed that mature cell SPs for hCEC injection therapy provide rapid recovery of CCT, better CECD, and low CECD attrition over 3 years postsurgery.
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