Clinical Outcomes of corneal transplantation in Patients with diabetic retinopathy
DOI:
https://doi.org/10.5281/zenodo.22812202Keywords:
corneal transplantation, diabetic retinopathy, keratoplasty, corneal endothelium, graft survivalAbstract
Background: Diabetes is associated with reduced corneal endothelial cell density, impaired epithelial barrier function, and diminished corneal nerve density, more pronounced with concurrent diabetic retinopathy [2,15].
Objective: This review synthesizes published evidence on clinical outcomes of corneal transplantation in patients with diabetes and diabetic retinopathy.
Methods: We synthesized specular and confocal microscopy studies of the diabetic cornea, multicenter keratoplasty registries including the Cornea Donor Study, and endothelial keratoplasty cohorts reporting diabetes as a covariate.
Findings: Diabetic corneas show reduced endothelial density and increased pleomorphism [8]; nerve loss and epithelial dysfunction correlate with retinopathy severity [15,12]; diabetes is associated with greater complications and reduced graft survival after penetrating keratoplasty [26,25]; endothelial keratoplasty offers comparable survival with less surface trauma [30,31].
Conclusions: Diabetic retinopathy marks the subset of patients with greatest corneal vulnerability; outcomes likely improve with endothelial keratoplasty where indicated, glycemic optimization, and epithelial surveillance [29,5].
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