Descemet stripping and automated endothelial keratoplasty (DSAEK) versus non-Descemet stripping and automated endothelial keratoplasty (nDSAEK) for bullous keratopathy

Yamazaki, Risa; Nejima, Ryohei; Ichihashi, Yoshiyuki; Tsubota, Kazuo; Shimmura, Shigeto

doi:10.1007/s10384-020-00767-8

Cited by 4 publications

(5 citation statements)

References 13 publications

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“…Clinical outcomes of nDSAEK have been reported to be similar to those of DSAEK 9,12,13,[27][28][29][30][31][32][33] . Several reports support the advantages of nDSAEK, particularly for failed PK, as stripping Descemet's membrane of failed PK may cause PK wound separation or weakness [27][28][29] .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, we 9 and others 10 , 11 eliminated Descemet stripping for bullous keratopathies in non-Fuchs type corneal endothelial dystrophy and referred to the modified procedure as non-Descemet Stripping Automated Endothelial Keratoplasty (nDSAEK) 9 . Moreover, both DSAEK and nDSAEK have proven quite effective for endothelial dysfunction, with rapid visual recovery and minimal induced astigmatism 9 , 12 , 13 .…”

Section: Introductionmentioning

confidence: 99%

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Graft rejection episodes after keratoplasty in Japanese eyes

Wajima

Hayashi

Kobayashi

et al. 2023

Sci Rep

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We aimed to investigate the clinical characteristics and risk factors for graft rejection after keratoplasty in Japanese patients. We enrolled 730 cases (566 patients) of penetrating keratoplasty (PK, N = 198), Descemet’s stripping automated endothelial keratoplasty (DSAEK, N = 277), non-Descemet’s stripping automated endothelial keratoplasty (nDSAEK, N = 138), and Descemet membrane endothelial keratoplasty (DMEK, N = 117). The incidence, clinical characteristics, and possible risk factors for graft rejection were analyzed. Graft rejection occurred in 65 cases (56 patients, 8.9%). The incidence rate of rejection was highest with PK (3.45/100 person-years), followed by DSAEK (2.34), nDSAEK (1.55), and DMEK (0.24). Cox regression analysis revealed keratoplasty type, younger age, indications (such as failed keratoplasty and infection), and steroid eyedrop use as possible risk factors. In the multivariate model adjusting baseline characteristics, PK and DSAEK had significantly higher hazard ratios (HRs) than DMEK (HR = 13.6, 95% confidence interval [CI] [1.83, 101] for PK, 7.77 [1.03, 58.6] for DSAEK). Although not statistically significant, the HR estimate of nDSAEK to DMEK (HR = 7.64, 95% CI [0.98, 59.6]) indicated higher HR in nDSAEK than in DMEK. DMEK is the favorable option among the four surgical procedures to avoid graft rejection after keratoplasty.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Graft rejection episodes after keratoplasty in Japanese eyes

Wajima

Hayashi

Kobayashi

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Clinical outcomes of nDSAEK have been reported to be similar to those of DSAEK. [8,11,12,[23][24][25][26][27][28][29] Several reports support the advantages of nDSAEK, particularly for failed PK, as stripping Descemet's membrane of failed PK may cause PK wound separation or weakness. [23][24][25] The histology and in vivo observation of the residual host endothelial cells after nDSAEK have already been thoroughly studied, including decreased density, loss of pump function, apoptosis, and altered morphology in a rabbit model by in vivo confocal microscopy.…”

Section: Discussionmentioning

confidence: 99%

“…[8] Moreover, both DSAEK and nDSAEK have proven quite effective for endothelial dysfunction, with rapid visual recovery and minimal induced astigmatism. [8,11,12] Although PK remains a viable option in the U.S., the number of DSAEK and DMEK procedures has dramatically increased in the past two decades, and the number of DSAEK and DMEK procedures was almost comparable by the end of 2021. [13] Recently, we reported a signi cant reduction in PK procedures while DSAEK/nDSAEK and DMEK procedures have signi cantly increased in our hospital.…”

Section: Introductionmentioning

confidence: 99%

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Graft rejection episodes after keratoplasty in Asian eyes

Wajima

Hayashi

Kobayashi

et al. 2022

Preprint

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This study aimed to investigate the clinical characteristics and risk factors for graft rejection after keratoplasty in Asian patients. We enrolled 730 cases (566 patients) of penetrating keratoplasty (PK, N = 198), Descemet’s stripping automated endothelial keratoplasty (DSAEK, N = 277), non-Descemet’s stripping automated endothelial keratoplasty (nDSAEK, N = 138), and Descemet’s membrane endothelial keratoplasty (DMEK, N = 117). The incidence, clinical characteristics, and possible risk factors of graft rejection were analyzed. Overall, graft rejection occurred in 65 cases (56 patients, 8.9%). The incidence of rejection was highest with PK (3.45/100 person-years), followed by DSAEK (2.34), nDSAEK (1.55), and DMEK (0.24). Cox regression analysis showed that keratoplaty type, younger age, indications (such as failed keratoplasty and infection), and steroid eyedrop use were possible risk factors. Furthermore, PK had the highest hazard estimate of rejection, with significant differences between PK and the other groups (P = 0.018, DSAEK; P = 0.022, nDSAEK; and P < 0.001, DMEK). No significant difference was observed between DSAEK and nDSAEK groups (P = 0.829) in terms of graft rejecton. The DMEK group had the lowest hazard estimate of rejection, with significant differences between DMEK and the other groups (P < 0.001, PK; P = 0.006, DSAEK; and P = 0.010, nDSAEK), confirming the superiority of this procedure.

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Long-term outcomes of Descemet stripping automated endothelial keratoplasty for bullous keratopathy after argon laser iridotomy

Mori

Kobayashi

et al. 2021

Jpn J Ophthalmol

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Descemet stripping and automated endothelial keratoplasty (DSAEK) versus non-Descemet stripping and automated endothelial keratoplasty (nDSAEK) for bullous keratopathy

Cited by 4 publications

References 13 publications

Graft rejection episodes after keratoplasty in Japanese eyes

Graft rejection episodes after keratoplasty in Japanese eyes

Graft rejection episodes after keratoplasty in Asian eyes

Long-term outcomes of Descemet stripping automated endothelial keratoplasty for bullous keratopathy after argon laser iridotomy

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