GT decreased after transplantation; however, there was a poor correlation of visual acuity with preoperative or postoperative DSAEK GT.

Purpose To determine the rates of keratoplasty for corneal endothelial disease (CED) from 2001–2009 in a large managed care network in the United States, factors that affect which patients undergo this procedure, and surgical outcomes. Design A retrospective review of data from a longitudinal cohort study. Participants Beneficiaries with CED aged ≥40 years who were receiving eye care during 2001–2009. Methods Rates of keratoplasty for CED were determined at 6-month intervals from January 2001 through December 2009. Mean number of postoperative visits and rates of severe adverse events in the year following keratoplasty surgery were monitored over the course of the decade. Univariate and multivariable logistic regression were performed to identify sociodemographic and other factors associated with undergoing keratoplasty for CED. Main Outcome Measures Odds of undergoing keratoplasty with 95% confidence intervals, changes in the number of postoperative visits and rates of adverse events in the year following keratoplasty. Results Of the 38,648 enrollees who met the inclusion criteria, 2,187 persons underwent one or more keratoplasty surgeries from January 2001 to December 2009. After adjustment for confounding factors, individuals with CED had a 47% increased odds of undergoing keratoplasty during 2007–2009 relative to 2001–2006. The mean number of postoperative visits to eye-care providers in the year following keratoplasty declined from 12.6 in 2001–2006 to 10.5 in 2007–2008. There was no difference in the proportion of enrollees who developed adverse events following keratoplasty over time. Conclusions In this analysis of claims data, from 2001–2009, a period during which there was a rise in the rate of endothelial keratoplasty, we observed a trend of greater rates of keratoplasty in patients with CED and fewer visits for postoperative care in the later years of the decade compared with the earlier years, along with no change in rates of severe adverse events.