Corneal Endothelial Cell Density Changes In Diabetic And Non-Diabetic Eyes In Grade 2 And Grade 3 Nuclear Sclerosis Undergoing Phacoemulsification

Background:Corneal endothelial cells are susceptible to mechanical trauma from ultrasound energy during phacoemulsification. Several studies have reported various results of phacoemulsification effect on corneal endothelial cells between diabetic and non-diabetic patients due to stressful events. Present study was aimed to evaluate corneal endothelial density, hexagonality and Central Corneal Thickness (CCT) changes between diabetic and non-diabetic patients at early postoperative period and 1 month after phacoemulsification.Material And Methods:Specular microscopy examinations prior to phacoemulsification and at early postoperative period and 1 months after phacoemulsification were performed on diabetic and non-diabetic groups in grade 2 and grade 3 nuclear sclerosis. Laterthe changes in endothelial density, the percentage of hexagonality, and Central corneal thickness were evaluated.Result:Mean age of 120 study sample was 58.45 years (standard deviation –8.498 years), with the highest 74 years and lowest 43 years. Therewere 53 (44%) females and 67 (56%) males in the study. 42 (35%) samples were from 51-60 years age group followed by 37 (30.83%) subjects in 61-70 years age group. Mean corneal endothelial cell density decreases after cataract surgery in comparison with pre-operative density among study samples. Mean pre-operative corneal endothelial cell density was lower in diabetics in comparison with non-diabetics, and the difference was statistically significant. Cell density count decreases after cataract surgery inboth groups with significant difference between two groups. Mean corneal endothelial cell morphology (hexagonal cell percentage) decreases after cataract surgery in comparison with pre-operative density among study sample s. Central corneal thickness increases in early postoperative period followed by normalisation at day 30.Conclusion:Diabetic group showed greater hexagonality decrease compared to non-diabetic group at 1 month after phacoemulsification. It is suggested that diabetic corneal endothelium requires additional care and protective measures during cataract surgery to minimize surgical trauma. There were no statistically significant differences in the endothelial loss and Central corneal thickness changes between the diabetic and non-diabetic group at 1 month follow up after phacoemulsification.

Long-term influence of donor graft thickness and size on corneal endothelial cell density of Descemet stripping automated endothelial keratoplasty / 中华实验眼科杂志

Objective:To explore the long-term influence of donor central graft thickness (CGT) and donor graft size on corneal endothelial cell density (ECD) after Descemet stripping automated endothelial keratoplasty (DSAEK).Methods:An observational case series study was conducted.One hundred and forty-four eyes of 134 patients who underwent DSAEK in Peking University Third Hospital from January 2013 to December 2017 with at least 24-month follow-up were enrolled.Preoperative donor ECD was evaluated by specular microscopy, and ECD was determined by in vivo confocal microscopy at 1, 3, 6, 12, and 24 months postoperatively.Donor CGT was measured by anterior segment optical coherence tomography.According to the 3-month postoperative donor CGT, the subjects were divided into thinner graft group (45 eyes with CGT<100 μm), medium-thick graft group (66 eyes with CGT≥100-<150 μm) and thicker graft group (33 eyes with CGT≥150 μm). According to the donor trephination size, the subjects were divided into smaller graft group (31 eyes with trephination size≥7-<8 mm) and larger graft group (113 eyes with trephination size≥8-<9 mm). The changes of the donor CGT and corneal endothelial cell loss rate were compared at different time points after surgery.The relationships between 24-month postoperative ECD and donor ECD, donor graft size and donor CGT were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Peking University Third Hospital (No.IRB00006761-2008025). Written informed consent was obtained from each subject prior to any medical examination. Results:The donor CGT was 129.0 (90.8, 160.8), 115.5 (93.0, 146.0), 115.5 (89.0, 151.0), 112.5 (94.3, 146.8) and 114.0 (89.0, 144.5) μm at 1, 3, 6, 12 and 24 months after surgery, showing a statistically significant difference ( H=37.369, P<0.001). There was a statistically significant difference between 1-month and 3-month postoperative CGT ( P<0.001). There was no statistically significant difference in the endothelial cell loss rate among the three different donor CGT groups and between the two different donor graft size groups at any postoperative time points (all at P>0.05). Spearman correlation analysis showed that the 24-month postoperative ECD was strongly positively correlated with the preoperative donor ECD( rs=0.783, P<0.001), which was not associated with donor graft size and donor CGT ( rs=0.141, P=0.093; rs=-0.044, P=0.600). Conclusions:Larger postoperative ECD is correlated with larger preoperative ECD of donor graft.Lower long-term corneal endothelial cell loss rate after DSAEK is associated with thinner and larger diameter of donor graft.

Correlation analysis of reject reaction and corneal endothelial cells after penetrating keratoplasty from donation after cardiac death / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To study the relativity between reject reaction from donation after cardiac death (DCD) and corneal endothelial cell source of corneal graft after penetrating keratoplasty.METHODS:Totally 28 cases of corneal graft rejection after penetrating keratoplasty with cardiac death donor cornea were analyzed using corneal endothelial microscope at less than 1mo,2-3mo,4-6mo,7-12mo after operation.RESULTS:Coefficient variation of corneal endothelial cell of the 28 cases at less than 1 mo,2-3mo,4-6mo and 7-12mo were 38.23％,49.56％,57.18％,65.04％.Corneal endothelial cell density were 2071.15 ± 311.47,1771.33 ± 348.18,1626.59±353.92,1553.14±307.31.The coefficient variation of corneal endothelial cells was positively correlated with rejection (r =0.95,P ＜ 0.05).The postoperative corneal endothelial cell density was negatively correlated with rejection (r=-0.93,P＜0.05).CONCLUSION:The corneal endothelial cell coefficient variation increased gradually and the corneal endothelial cell density decreased gradually after DCD corneal allograft rejection.Corneal endothelial cell coefficient variation and corneal endothelial cell density can be used as indicators of early detection of postoperative rejection.

Effect of Ahmed glaucoma drainage valve implantation on corneal endothelial cell density and intraocular pressure in patients with neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effect of Ahmed glaucoma drainage valve implantation on corneal endothelial cell density and intraocular pressure in patients with neovascular glaucoma.METHODS:Totally 200 cases (200 eyes) of patients with neovascular glaucoma in our hospital from June 2013 to June 2016 were enrolled in this study.All patients were treated with glaucoma drainage valve implantation.The medical records of the patients were retrospectively analyzed;the evaluation of operation completion was made;intraocular pressure at preoperative and postoperative 1wk,1mo,1a was detected using non-contact tonometry;the corneal endothelial cell density at preoperative and postoperative 1 wk,1mo and 1 a was tested by corneal endothelial microscopy,and visual acuity of patients before operation and at 1 a after operation was recorded.All patients' complications and intervention methods were followed-up and recorded.RESULTS:All patients' complete success rate was 81.0％,the conditional success rate was 92.0％.The proportion of preoperative and postoperative vision without light perception,hand moving to 0.01,0.02-0.05,0.06-＜0.10,≥0.10 had significant difference (P＞0.05).Intraocular pressure before treatment was 42.43±3.43mmHg,and were 13.45 ± 2.34mmHg,15.89 ± 2.67mmHg,16.34±2.88mmHg at 1wk,1mo and 1a after operation respectively,showing significant difference (F=4570.62,P＜ 0.001).Before treatment,corneal endothelial cell density was 2453.67± 342.34/mm2,and were 2216.67-± 332.32/mm2,2087.34 ± 326.45/mm2,1959.67±303.34/mm2 at 1wk,1mo and 1 a after operation respectively,holding significantly different (F=83.42,P＜0.001).There were macular degeneration 20 eyes of hyphema,13 eyes of low pressure,8 eyes of drainage valve displacement and 21 eyes of shallow anterior chamber.CONCLUSION:Ahmed glaucoma drainage valve implantation for neovascular glaucoma can effectively control intraocular pressure but the presence of corneal endothelial cell loss exists,can effectively protect and recover residual vision of patients,relief complications and recover it after simple intervention,it is an effective method for neovascular glaucoma.

Effect of small incision non-phacoemulsification cataract surgery on corneal endothelial cell / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the effect of small incision non-phacoemulsification cataract surgery on corneal endothelial cell.METHODS:Totally 140 cataract patients (152 eyes) treated in our hospital from August 2013 to March 2016 were selected.All of the patients underwent small incision non-phacoemulsification cataract surgery.Before surgery and at 1wk, 1mo and 3mo after surgery, we measured the corneal endothelium of upper cornea, the central cornea and the lower part of cornea.The proportion and density of hexagonal cells, loss rate and cell area in corneal endothelial cells were calculated and compared.RESULTS:Postoperatively 36 eyes had posterior elastic layer folds, aqueous flare, which disappeared after treatment.After surgery, corneal incision was found to have mild corneal edema.No other complications were found.A total of 128 patients (137 eyes) were followed up for a total of up to 3mo, with a loss of follow-up in 12 patients (15 eyes).After surgery, corneal endothelial cell density of the upper part of the cornea, the central cornea and the lower part of cornea, was statistically significantly different with each other (F=3.526, P=0.031), the difference in different time points was statistically significant (F=4.111, P=0.018).The postoperative corneal endothelial cell loss rate was statistically significant different between the three groups (F=3.526, P=0.031), at different time pionts (F=4.111, P=0.018).There was statistical significance of percentage of hexagonal cells between the three groups (F=4.348, P=0.014), the difference was significantly different between different time points (F=4.964, P=0.008).There was statistical significance of corneal endothelial cell area between the three groups (F=3.180, P=0.044), the difference was significantly different between the time points (F=3.511, P=0.032).CONCLUSION:After small incision non-phacoemulsification cataract surgery, corneal endothelial cell density decreased, hexagonal cell proportion decreased, corneal cell area expanded.

Effect of two different surgeries on corneal endothelial cells in grade Ⅱ - Ⅲ lens nucleus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effect of small incision extracapsular cataract extraction and phacoemulsification on corneal endothelial cells and explore the differences between these two most commonly used surgeries for grade Ⅱ-Ⅲ lens nucleus. · METHODS: Retrospective study. We retrospectively evaluated the data of age-related cataract patients who had completed surgery in our hospital between June 2013 and December 2015. There were 84 eyes of 84 patients. The corneal endothelial cell density of all the patients were greater than 2000/mm2 and lens nucleus were gradeⅡ- Ⅲ. The patients were divided into manual small incision cataract surgery ( MSICS ) group and phacoemulsification ( Phaco ) group. MSICS group included 42 cases (42 eyes) and Phaco group included 42 cases ( 42 eyes ) . Postoperative evaluations were performed at 1d, 1wk, 1mo and 6mo and included uncorrected visual acuity ( UCVA ) , corneal endothelial cell density and the proportion of hexagonal cells. · RESULTS: There were no statistically significant differences of the two groups in preoperative basic data, UCVA, corneal endothelial cell density and the proportion of hexagonal cells, nuclear classification. The postoperative UCVA were significantly improved in both groups (x2=148. 01, P0. 05). ·CONCLUSION: Manual small incision cataract surgery and phacoemulsification can indiscriminately improve UCVA and decrease the density of corneal endothelial cells. However, the change of hexagonal cells proportion was not obvious. These two surgeries for cataract patients with corneal endothelial cell density greater than 2000/mm2 , grade Ⅱ-Ⅲ lens nucleus have similar efficacy and safety.

Corneal Endothelial Cell Loss after Tube Shunt Surgery in Fuch's Heterochromic Iridocyclitis

PURPOSE: To report a case of corneal failure after implantation of the Ahmed glaucoma valve occurring in a patient diagnosed with Fuchs' heterochromic iridocyclitis. CASE SUMMARY: A 53-year-old male who complained of ocular pain and suddenly decreased visual acuity in his right eye visited our clinic. His visual acuity was 0.15 and intraocular pressure (IOP) was 55 mm Hg. The slit-lamp examination revealed edematous cornea, fine round or stellate keratic precipitates connected with fine filaments on the endothelium and depigmentation of the iris. The corneal endothelial cell density was 2,958 cells/mm2. There was no specific finding in his left eye. The IOP did not improve with medical treatment, therefore, an Ahmed glaucoma valve was implanted in his right eye. At every follow-up exam the tube was well positioned and the IOP was maintained between 8 and 13 mm Hg. Eight months postoperatively, the patient complained of decreased visual acuity and the cell density was decreased to 1,408 cells/mm2. Posterior subcapsular cataract opacity was observed as well as progression of depigmentation and distortion of the iris. Seventeen months after the surgery, the cell density was 700 cells/mm2. On follow-up examination, his visual acuity was decreased to FC10 cm with the cataract progressing, therefore cataract surgery was performed. One month postoperatively, his vision improved to 0.1. However, the visual acuity deteriorated due to progression of the corneal edema and penetrating keratoplasty was performed. CONCLUSIONS: Aggravation of the corneal complication after Ahmed glaucoma valve implantation should be considered in patients with Fuchs' heterochromic iridocyclitis-induced glaucoma.

Central Corneal Thickness and Corneal Endothelial Cells in Pseudoexfoliation Syndrome

PURPOSE: To evaluate the central corneal thickness (CCT) and corneal endothelial cell density (ENDO) in pseudoexfoliation syndrome. METHODS: Medical records of patients who underwent a preoperative examination for cataract surgery and an examination for glaucoma were retrospectively reviewed. The present study included 44 patients (59 eyes) and age- and sex-matched controls. The total pseudoexfoliation patients divided into 2 groups, such as pseudoexfoliation syndrome (28 eyes) and pseudoexfoliative glaucoma (21 eyes) .The intraocular pressure (IOP), CCT, ENDO, corneal curvature (CC) and axial length (AL) were measured. RESULTS: The total pseudoexfoliation group showed significantly higher IOP (p = 0.001), thinner CCT (p = 0.003) and lower ENDO (p = 0.037). The pseudoexfoliation syndrome group showed significantly thinner CCT (p = 0.010) and lower EDNO (p = 0.041), but no significant difference in IOP (p = 0.941). There was no significant difference in CCT (p = 0.060) and ENDO (p = 0.171) between the pseudoexfoliative glaucoma group and controls, but the pseudoexfolliative glaucoma group showed significantly higher IOP (p < 0.001). CONCLUSIONS: The pseudoexfoliation group showed thinner CCT which should be taken into consideration when evaluating IOP with the applanation tonometer and diagnosing glaucoma, especially in pseudoexfoliation syndrome patients.

Comparison of Surgical Outcomes between Trabeculectomy and Aqueous Shunt Surgery in Patients with Iridocorneal Endothelial Syndrome

PURPOSE: To compare surgical outcomes and corneal endothelial cell densities in patients with glaucoma secondary to iridocorneal endothelial (ICE) syndrome who underwent trabeculectomy with mitomycin-C (MMC) versus those who underwent Ahmed Glaucoma Valve (AGV) implantation. METHODS: Twenty-one patients with ICE syndrome who underwent either trabeculectomy with MMC or AGV implantation were included in this study. All patients had more than 12 months of follow-up after glaucoma surgery. Intraocular pressure (IOP), visual acuity (VA) and corneal endothelial cell density were compared according to the method of surgery. RESULTS: Ten eyes had undergone a trabeculectomy with MMC, and 11 eyes had an AGV implantation. In eyes that underwent a trabeculectomy with a MMC, there were no statistically significant differences between preoperative and postoperative month 12 in IOP, VA or corneal endothelial cell density. In eyes that underwent AGV implantation, postoperative IOP, VA and corneal endothelial cell density were statistically significantly lower than the preoperative values. CONCLUSIONS: When determining the method of glaucoma surgery in patients with ICE syndrome, the additional procedures needed to maintain the surgical success of trabeculectomy with MMC and the corneal decompensation which is caused by a decrease in corneal endothelial cell density after AGV implantation should be considered.

The Effect of Intraocular Lens Insertion Sequence during the Triple Procedure on Corneal Endothelial Cell Survival

PURPOSE: To evaluate the differences in corneal endothelial cell density in patients undergoing intraocular lens insertion at 2 different sequences during the triple procedure. METHODS: The present retrospective study divided 37 eyes of 37 patients and into 2 groups: trephination, phacoemulsification and intraocular insertion, followed by graft suturing (20 eyes, Group I), and trephination, phacoemulsification, graft suturing leaving 3 mm gap, followed by intraocular lens insertion and suturing of the gap (17 eyes, Group II). Intraocular pressure, corneal thickness, and endothelial cell density were measured for 3 months postoperatively. RESULTS: No significant difference in intraocular pressure between the 2 groups (p = 0.14) was observed. However in Group II, the mean corneal thickness showed a greater decrease (p = 0.02) during the 3 months following surgery, and the mean corneal endothelial cell density in this group was higher at 1, 2, and 3 months postoperatively than that of Group I (p = 0.01, 0.02 and 0.04 respectively). There were no significant difference in the rate of endothelial cell loss during the postoperative period between the 2 groups. CONCLUSIONS: The anterior chamber formation before intraocular lens insertion in the triple procedure is hypothesized to decrease corneal endothelial cell loss by minimizing mechanical contact with intraocular structures or intraocular lenses during surgery.

The Effect of Silicone Oil Injection Corneal Endothelium / 医学研究杂志

Objective To study the changes of corneal endothelium after silicone oil tamponade.Methods This trial involved 81 cases (81 eyes) who received vitrectomy with tamponade of silicone oil or vitrectomy and lensectomy with tamponade of silicone oil. The changes of corneal endothelium were observed before surgery and 1week, 1 month, 3 month, 6 month after surgery. Results The mean corneal endothelial cell densities was significantly decreased after surgery in all cases (P

Evaluation of Donor Corneal Endothelium after Keratoplasty

PURPOSE: To investigate the difference in donor corneal cell changes after penetrating keratoplasty in various corneal diseases. METHODS: Subjects included 36 eyes from 35 people with at least 6 months of follow-up who had undergone penetrating keratoplasty between August 2000 and December 2002. The patients were classified into three groups based on the state of the corneal endothelium. Changes in cell density, polymorphisms, and polymegathism of the donor cornea were compared between groups. Results were analyzed by ANOVA. RESULTS: The overall corneal endothelial cell density after grafting was lower, but the differences in endothelial cell states between the recipient cases were not statistically significant. The change in corneal endothelial cell density showed a significantly higher difference (p=0.0013) when patients had either undergone a rejection episode during recovery or recurred herpetic uveitis. CONCLUSIONS: The preoperative state of the corneal endothelium may affect the survival of donor corneal endothelium after grafting. However, rejection of the transplant contributes more significantly to the survival of the donor corneal endothelium than other factors. We suggest close observation and keen therapy with respect to rejection after grafting.

Evaluation of Donor Corneal Endothelium after Keratoplasty

PURPOSE: To investigate the difference in donor corneal cell changes after penetrating keratoplasty in various corneal diseases. METHODS: Subjects included 36 eyes from 35 people with at least 6 months of follow-up who had undergone penetrating keratoplasty between August 2000 and December 2002. The patients were classified into three groups based on the state of the corneal endothelium. Changes in cell density, polymorphisms, and polymegathism of the donor cornea were compared between groups. Results were analyzed by ANOVA. RESULTS: The overall corneal endothelial cell density after grafting was lower, but the differences in endothelial cell states between the recipient cases were not statistically significant. The change in corneal endothelial cell density showed a significantly higher difference (p=0.0013) when patients had either undergone a rejection episode during recovery or recurred herpetic uveitis. CONCLUSIONS: The preoperative state of the corneal endothelium may affect the survival of donor corneal endothelium after grafting. However, rejection of the transplant contributes more significantly to the survival of the donor corneal endothelium than other factors. We suggest close observation and keen therapy with respect to rejection after grafting.

Corneal Endothelial Cell Change after Phacoemulsification according to the Severity of Diabetic Retinopathy

PURPOSE: To evaluate the change of corneal endothelial cell morphology after phacoemulsification according to the degree of the severity of diabetic retinopathy. METHODS: Preoperative and postoperative 6 months after phacoemulsification, the specular microscopy was performed on all the subjects. The patients were divided into three groups: Group I (n=30 eyes), non diabetic, Group II (n=30 eyes), diabetes with non proliferative diabetic retinopathy (NPDR), and Group III (n=30 eyes), diabetes with proliferative diabetic retinopathy (PDR). RESULTS: Postoperative corneal endothelial cell density and hexagonality significantly decreased, and cell size variation coefficient increased in all groups compared to preoperative stage (P<0.001). At the postoperative 6 months, corneal endothelial cell density was significantly decreased in all groups (P<0.001). Cell size variations were significantly increased in Group III compared to Group I and Group II (P<0.05), but the percentage of hexagonal cell was not significantly decreased in all groups (P=0.082). CONCLUSIONS: Corneal endothelial cell density significantly decreased and cell size variation coefficient significantly increased in diabetic retinopathy patients undergoing phacoemulsification compared to normal. Therefore, it may be necessary to observe for the postoperative corneal complications in the proliferative diabetic retinopathy after phacoemulsification.

Corneal Endothelial Morphometric Changes after Laser in Situ Keratomileusis with Residual Thickness less than 250 micro meter

PURPOSE: To evaluate endothelial cell changes following LASIK with residual corneal thickness of less than 250 micro meter. METHOD: We performed noncontact specular microscopy preoperatively, and 1 week, 1, 3, 6, 9 months after surgery to examine 82 eyes which had undergone LASIK. Corneal endothelial density (CD), coefficient of variation of the cell area (CV), and the percentage of hexagonal cells(hexagonality, 6A) were obtained according to the corneal endothelial cell analysis program. Analysis was done according to the parameters such as residual stromal bed thickness, number of laser pulse and percentage of ablated stromal thickness and preoperative spherical equivalent. RESULTS: Changes in CD and CV showed no significant difference throughout the follow-up period after surgery. Hexagonality, however, decreased after surgery. In particular, corneas with residual thickness of less than 235 micro meter or the number of laser pulse over than 400, or ablation more than 30% of stromal thickness showed significant decrease in hexagonality. CONCLUSIONS: This results suggest that LASIK with deep ablation might cause corneal endothelial damages, and at least 235 micro meter or more of residual thickness should be preserved to avoid endothelial damages.

Comparision of central Corneal Endotherial Cell Density with Peripheral Areas According to Age by Specular Microscopy

We measured corneal endothelial cell density of 100 normal eyes of 50 Korean volunteers on central, superior, inferior, nasal and temporal aspect, respectively. Non-contact specular microscopy were used for measurement. The data thus obteined were analyzed according to the following parameters: age, laterality, sex and location(central vs. peripheral). Corneal endothelial cell density showed gradual decrement with age, but no significant statistically differences with laterality and sex. The results showed a large difference in corneal endothelial cell density depending on the location, although they failed to show statistical significant(P>0.05).

The Effects of Pars Plana Vitrectomy on the Corneal Endothelium

The objective of this study was to examine the effects of pars plana vitrectomy on the corneal endothelium. Thirty-one patients scheduled for pars plana vitrectomy were enrolled in this prospective study. Specular microscopic examination to check central corneal thickness (CCT) and central corneal endothelial density (CCED) was underwent at preoperatively and 1 week, 1 month, 2 months postoperatively. The duration of intravitreal irrigation and the volume of solution were checked also. Transient corneal edema and decrease in endothelial cell density with statistical significance was observed at 1 week postoperatively. We found that neither duration of intraocular irrigation nor the volume of solution used is related with corneal changes. The eyes with combined lensectomy showed more severe corneal edema and significant greater reduction of endothelial cell density at 1 month and 2 months postoperatively compared to phakic eyes. Diabetic eyes also showed a significant greater reduction of endothelial cell density at 2 months postoperatively compared to nondiabetic eyes.

The Effect of Excimer Laser Photorefractory Keratectomy on Density of Corneal Endothelial cells

To investigate the effect of 193 nm ArF excimer laser photorefractive keratectomy(PRK) on corneal endothelium, 18 patients(30 eyes), undergone PRK at department of ophthalmology of Seoul National University Hospital from August to December 1994, were analyzed according to their preoperative contact lens use or not, amount of attempted correction (6D over or under) and postoperative topical steroid use or not. The central corneal endothelial cell density was measured before and 1 week, 2 months after PRK. Differences of the central corneal endothelial cell density between contact lens user and nonuser, myopes over 6D and under 6D, and steroid user and non-user were not statistically significant.

Clinical Evaluation of Corneal Trasplantion of 326 Cases

Corneal transplantation of three hundred and twenty five cases operated at the Department of Ophthalmology, Kangnam St. Mary's Hospital, Catholic University Medical College from May 1980 to December 1987 were clinically evaluated. The follow up period ranged from 1 month to 6 years(mean: 3 3/4 years). Major causes of corneal opacity were keratitis(105 eyes, 32.3%) and trauma(50 eyes, 15.4%), followed by keratoconus(50 eyes, 15.4%) and bullous keratopathy(46 eyes, 14.2%). There were 233 eyes of partial penetrating keratoplasty, 59 eyes of lamellar keratoplasty, 4 eyes of keratoplasty with IOL implantation and 29 eyes of prostho-keratoplasty. Success rate was 74.3% by maintaining clarity among 220 eyes out of 296 eyes except of cases of prostho-keratoplasty. Among the 76 eyes with graft opacity, 35 eyes were caused by graft rejection and 19 eyes, by bullous keratopathy. Among the cases of keratoplasty, 112 eyes showed postoperative bestcorrected visual acuity of 0.5 or higher(35.2%), 134 eyes were between 0.1 and 0.4(42.1%), and 246 eyes were 0.1 or higher(77.3%). Corneal endothelial cell density change from before the corneal transplantation was 42.3% decrease at 1 year post-operatively and 18.4% decrease at 3 months postoperatively.