Liaboe Chase A, Aldrich Benjamin T, Carter Pamela C, Skeie Jessica M, Burckart Kimberlee A, Schmidt Gregory A, Reed Cynthia R, Zimmerman M Bridget, Greiner Mark A
*Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA; †Cornea Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA; ‡Iowa Lions Eye Bank, Coralville, IA; and §Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA.
Cornea. 2017 May;36(5):561-566. doi: 10.1097/ICO.0000000000001174.
To quantify changes in endothelial cell density (ECD) of donor corneal tissue in relation to the presence or absence of a medical history of diabetes mellitus diagnosis, treatment, and complications.
A retrospective review was performed for all corneas collected at Iowa Lions Eye Bank between January 2012 and December 2015. For purposes of analysis, donor corneas were divided into 4 groups: nondiabetic, non-insulin-dependent diabetic, insulin-dependent diabetic without medical complications due to diabetes, and insulin-dependent diabetic with medical complications due to diabetes. ECD values (obtained through specular microscopy) and transplant suitability for endothelial transplantation (determined by the standard protocol of the eye bank) were compared among groups using linear mixed model analysis.
In total, 4185 corneas from 2112 donors were included for analysis. Insulin-dependent diabetic samples with medical complications due to diabetes (N = 231 from 119 donors) showed lower ECD values compared with nondiabetic samples (-102 cells/mm, P = 0.049) and non-insulin-dependent diabetic samples (-117 cells/mm, P = 0.031). ECD values did not differ significantly among the remaining groups. The likelihood of suitability for endothelial transplantation did not differ among all 4 groups.
Corneas from donors with insulin-dependent diabetes mellitus and medical complications resulting from the disease have lower mean ECD values compared with other donors. However, our analysis suggests that these corneas are equally likely to be included in the donor pool for corneal transplantation. Additional studies are needed to determine the mechanism(s) contributing to cell loss in donors with advanced diabetes and to assess associated endothelial cell functional impairment.
量化供体角膜组织内皮细胞密度（ECD）的变化，这些变化与糖尿病诊断、治疗及并发症的病史存在与否相关。
对2012年1月至2015年12月间爱荷华狮子眼库收集的所有角膜进行回顾性研究。为便于分析，将供体角膜分为4组：非糖尿病组、非胰岛素依赖型糖尿病组、无糖尿病相关并发症的胰岛素依赖型糖尿病组以及有糖尿病相关并发症的胰岛素依赖型糖尿病组。采用线性混合模型分析比较各组间的ECD值（通过镜面显微镜获得）及内皮移植的移植适宜性（由眼库的标准方案确定）。
总共纳入了来自2112名供体的4185只角膜进行分析。有糖尿病相关并发症的胰岛素依赖型糖尿病样本（来自119名供体的231份样本）与非糖尿病样本相比，ECD值较低（-102个细胞/mm²，P = 0.049），与非胰岛素依赖型糖尿病样本相比也较低（-117个细胞/mm²，P = 0.031）。其余各组间ECD值无显著差异。所有4组间内皮移植适宜性的可能性无差异。
与其他供体相比，患有胰岛素依赖型糖尿病且有该疾病相关并发症的供体角膜平均ECD值较低。然而，我们的分析表明，这些角膜被纳入角膜移植供体库的可能性相同。需要进一步研究以确定导致晚期糖尿病供体细胞丢失的机制，并评估相关的内皮细胞功能损害。
