• Jinyang Li, Lechu Yu, Zifeng Deng, Lihua Wang, Li Sun, Huixiang Ma, and Wei Chen.
• School of Ophthalmology and Optometry, Wenzhou Medical College, Zhejiang, China.
• Am. J. Ophthalmol. 2011 Nov 1; 152 (5): 762-70.e3.

PurposeTo determine whether deep anterior lamellar keratoplasty (DALK) using acellular glycerol-cryopreserved corneal tissue (GCCT) could prevent allograft rejection in high-risk corneas.DesignProspective, randomized, comparative study.MethodsSettingsThe Eye Hospital, Wenzhou Medical College, Zhejiang, China.Study PopulationAll patients with herpes simplex virus keratitis, bacterial keratitis, fungal keratitis, or ocular burn, who were eligible as per study design, were invited to participate.Observation ProceduresAccording to randomized block design, all patients received either GCCT or fresh corneal tissue (FCT) during DALK. Best-corrected visual acuity (BCVA), slit-lamp microscopy, and in vivo confocal microscopy examinations at 1 week and 1, 3, 6, 12, and 24 months after surgery were analyzed. Kaplan-Meier survival analysis was used to evaluate graft survival rate.Main Outcome MeasuresTherapeutic success, 2-year rejection-free graft survival rate and 2-year graft survival rate, in vivo confocal microscopy results, BCVA, and endothelial cell density.ResultsPostoperative BCVA of 20/40 or better at the last follow-up visit was achieved in 57.6% (19/33) of eyes in the GCCT group and in 54.8% (17/31) of the FCT group. No graft rejection occurred in the GCCT group, while in the FCT group 10 episodes of stromal rejection developed in 7 eyes. Overall, the rejection-free graft survival rate at 2 years was significantly higher in the GCCT group as compared with the FCT group (100.0%, 78.8% respectively, P = .006).ConclusionsDeep anterior lamellar keratoplasty using acellular glycerol-preserved cornea could prevent allograft rejection and promote graft survival rate in high-risk corneas.Copyright © 2011 Elsevier Inc. All rights reserved.

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