Current Ophthalmology Reports

, Volume 7, Issue 2, pp 89–97 | Cite as

Clinical Factors for Rapid Endothelial Cell Loss After Corneal Transplantation: Novel Findings From the Aqueous Humor

  • Hiroyuki Yazu
  • Takefumi YamaguchiEmail author
  • Kazuo Tsubota
  • Jun Shimazaki
Cornea (P Hamrah and T Yamaguchi, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Cornea


Purpose of Review

To review the clinical factors for endothelial cell density (ECD) loss and graft failure after corneal transplantation.

Recent Findings

Reduction of ECD after corneal transplantation is associated with various clinical factors, such as the presence of glaucoma, graft diameter, donor age, donor diabetes, and donor gender. Recently, we reported the severe preexisting iris damage was one of the clinical factors for rapid ECD loss and graft failure. We also showed that preexisting iris damage causes chronic elevation of cytokine levels in the aqueous humor (AqH). Furthermore, the higher preoperative levels of specific cytokines in the AqH were associated with a rapid reduction in ECD after penetrating keratoplasty and endothelial keratoplasty.


Iris damage and preoperative cytokine levels in the AqH can be potential biomarkers for the reduction of ECD after corneal transplantation, although we need to substantiate the exact mechanism of the endothelial cell loss.


Corneal transplantation Corneal endothelial cell Iris damage Aqueous humor Cytokine 



Part of this work was supported by a Grant-in-Aid for Scientific Research (15K10906, 20383771) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology and a Grant from Uehara Scientific Foundation (TY, Tokyo Japan).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hiroyuki Yazu
    • 1
    • 2
    • 3
  • Takefumi Yamaguchi
    • 1
    • 2
    Email author
  • Kazuo Tsubota
    • 2
  • Jun Shimazaki
    • 1
    • 2
  1. 1.Department of OphthalmologyTokyo Dental College Ichikawa General HospitalIchikawaJapan
  2. 2.Department of OphthalmologyKeio University School of MedicineTokyoJapan
  3. 3.Department of OphthalmologyTsurumi University School of Dental MedicineYokohamaJapan

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