Follow-up study of human corneal endothelial cells, photographed in vivo before enucleation and 20 years later in grafts.

Purpose: To evaluate the long-term (20-year) survival of transplanted human corneal endothelial cells.

Methods: The donor endothelium had been photographed 20 years ago with a specular microscope both before enucleation in the melanomatous eye and in situ after keratoplasty. The same donor endothelial cells were now photographed again 20 years later with a modern specular microscope to ascertain the morphology and cell density of the grafts.

Results: In the earlier study the mean postoperative endothelial cell density was 1357+/-543 cells/mm2, the average cell loss 11 months postoperatively being 48.2%; 20.5 years postoperatively the cell loss was 62.9% of the preoperative cell count. In our well-documented patient population the endothelial cell loss during the last 19 years had been only 14.7%, which amounts to a cell loss of less than 1% per year.

Conclusion: In transplanted corneas, the main endothelial cell loss seems to take place during the first 1-2 postoperative years.