Comparative outcomes of penetrating and component endothelial cell corneal allografts in outbred sheep

dc.contributor.author Mills, Richard Arthur
dc.contributor.author Klebe, Sonja
dc.contributor.author Coster, Douglas John
dc.contributor.author Williams, Keryn Anne
dc.date.accessioned 2013-09-03T04:47:33Z
dc.date.available 2013-09-03T04:47:33Z
dc.date.issued 2012-12-04
dc.description.abstract Lamellar (component-cell) corneal transplantation is replacing penetrating keratoplasty for some corneal disorders in humans; but the relative risks of immunological graft rejection for the two procedures are uncertain. A model of component endothelial cell keratoplasty (endokeratoplasty) was developed in the outbred sheep. Clinical and histological graft outcomes after endokeratoplasty were then compared with contemporaneous penetrating corneal allografts. No topical or systemic immunosuppression was administered to any recipient sheep. Endothelial cell allografts (n = 10) took significantly longer to achieve perfect transparency following surgery than did penetrating corneal grafts (n = 7) (day 10 versus day 4; p = 0.003; two-tailed Mann- Whitney U-test). The median day to rejection of penetrating grafts was post-operative day 18; and of endothelial cell grafts was day 48 (p = 0.04; two-tailed Mann-Whitney U-test). The clinical courses of the two procedures were quite different. Penetrating grafts gained clarity quickly but exhibited rapid graft neovascularization. Clinical rejection was preceded by inflammation in the anterior segment. Endothelial cell grafts exhibited a fluctuating; more indolent course of opacification; although all did eventually fail. Histological analysis confirmed immunological rejection in all failed grafts; but with different patterns of leukocytic infiltration in endokeratoplasties compared with penetrating keratoplasties. Inflammatory cells in endothelial cell grafts were generally fewer in number and were more often found in the posterior stroma. We conclude that in the absence of immunosuppression; all endothelial cell allografts do undergo immunological rejection; albeit at a slower tempo than penetrating grafts. en
dc.description.sponsorship This work was funded by the Ophthalmic Research Institute of Australia. KAW is supported by the Australian National Health & Medical Research Council (NHMRC). en
dc.identifier.citation Mills, R.A.D., Klebe, S., Coster, D.J. and Williams, K.A., 2012. Comparative outcomes of penetrating and component endothelial cell corneal allografts in outbred sheep. Cell Transplantation, 2012 Dec 4 [Epub ahead of print PMID: 23211557]. en
dc.identifier.doi https://doi.org/10.3727/096368912X659835 en
dc.identifier.issn 0963-6897
dc.identifier.uri http://hdl.handle.net/2328/27026
dc.language.iso en
dc.publisher Cognizant Communication Corporation en
dc.relation http://purl.org/au-research/grants/nhmrc/1002044 en
dc.relation http://purl.org/au-research/grants/nhmrc/535000 en
dc.relation.grantnumber NHMRC/1002044 en
dc.relation.grantnumber NHMRC/535000 en
dc.rights © 2012 Cognizant Communication Corporation en
dc.rights.holder Cognizant Communication Corporation en
dc.rights.license In Copyright
dc.subject Opthalmology en
dc.subject Corneal grafting en
dc.title Comparative outcomes of penetrating and component endothelial cell corneal allografts in outbred sheep en
dc.type Article en
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