ABSTRACT
Objective To analyze the outcome of descemet's stripping with endothelial keratoplasty (DSEK) in high-risk rabbit model and its immunological rejection.Methods Together 28 rabbits with corneal neovascularization beyond three quadrants were randomly divided into 2 groups (n =14) according to the surgical procedures,and they were penetrating keratoplasty (PK) and DSEK groups,with the right ones chosen as the experimental eyes in all rabbits.The corneal allograft condition (opacity,edema and neovascularization) was examined by the slit lamp biomicroscopy for 8 weeks,and rejection index (RI) and neovascularization index (NI) were recorded.The corneal sections were stained using hematoxylin-eosin for histopathological evaluation.Then IL-2,IL-10 and vascular endothelial growth factor (VEGF) mRNA expression were quantified by RT-PCR.Results Anterior segment photographs showed corneal opacity,edema and neovascularization appeared in most rabbits of PK group,but few rabbits in the DSEK group did not have above complications.The corneal allograft rejection occurred in 13 eyes (92.9％) in PK group,which was significantly higher than that in DSEK group (4 eyes,28.6％ ％) (P ＜ 0.05).Histology examination showed that more mononuclear cell infiltration appeared in PK group,which was more enhanced than that in DSEK group.Moreover,significantly up-regulation expression of IL-2,IL-10 and VEGF mRNA was observed in PK group when compared with DSEK group.Conclusion These results suggest that corneal allograft rejection has less frequency and less severity after DSEK than after PK,suggesting endothelial keratoplasty could be an ideal strategy for the treatment of corneal endothelial disorders.