Endothelial Keratoplasty

Terry, Mark A.; Shamie, Neda; Chen, Edwin S.; Hoar, Karen L.; Friend, Daniel J.

doi:10.1016/j.ophtha.2007.09.005

Cited by 227 publications

(48 citation statements)

References 31 publications

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“…Outstanding results from DSAEK have been reported in the literature. [91011] There have been other cohort studies comparing outcomes of DSAEK in Fuchs’ endothelial dystrophy versus pseudophakic bullous keratopathy in a larger sample size. The present study, however, was performed by a single surgeon which can add new and relevant information for the Middle-Eastern patient population.…”

Section: Discussionmentioning

confidence: 99%

Descemet stripping automated endothelial keratoplasty in Fuchs′ endothelial dystrophy versus pseudophakic bullous keratopathy

Javadi¹,

Feizi²,

Jafari³

et al. 2016

J Ophthalmic Vis Res

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Purpose:To compare clinical and confocal scan outcomes after Descemet stripping automated endothelial keratoplasty (DSAEK) performed for Fuchs’ endothelial dystrophy (FED) versus pseudophakic bullous keratopathy (PBK).Methods:This retrospective comparative study included 47 consecutive eyes of 39 patients with the diagnosis of FED (n = 29, group 1) or PBK (n = 18, group 2) that underwent DSAEK. Clinical outcomes were compared between the study groups. At the final follow-up examination, confocal microscopy was used to measure and compare central corneal and graft thickness as well as endothelial cell density and morphology between the two groups.Results:Mean age at the time of surgery was 65.2 ± 11.8 and 69.4 ± 12.5 years in groups 1 and 2, respectively (P = 0.27). Follow-up period was 23.6 ± 14.0 months in group 1 and 25.6 ± 15.7 months in group 2 (P = 0.79). Postoperative best spectacle-corrected visual acuity was significantly better in group 1 than in group 2 until postoperative month 6. Afterwards, the two study groups were comparable in this regard. At the final follow-up examination, spherical equivalent refractive error was + 0.39 ± 1.46 diopters (D) in group 1 and + 0.80 ± 1.47 D in group 2 (P = 0.45). Postoperative keratometric astigmatism was 1.02 ± 0.83 D and 2.36 ± 0.67 D, respectively (P < 0.001). Mean central graft thickness was 98.0 ± 33.3 μm in group 1 and 107.6 ± 28.0 μm in group 2 (P = 0.45). No statistically significant difference was observed between the two groups in terms of the postoperative endothelial cell density.Conclusion:The outcomes of DSAEK surgery were comparable between FED and PBK. All grafts were clear despite the lower than normal endothelial cell counts.

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Section: Discussionmentioning

confidence: 99%

Descemet stripping automated endothelial keratoplasty in Fuchs′ endothelial dystrophy versus pseudophakic bullous keratopathy

Javadi¹,

Feizi²,

Jafari³

et al. 2016

J Ophthalmic Vis Res

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“…The same surgical technique was used for all patients 8 . In brief, a temporal, 5 mm scleral tunnel incision was used and Descemet's membrane was stripped under sodium hyaluronate (Healon, Abbott Medical Optics).…”

Section: Methodsmentioning

confidence: 99%

Association Between Transient Interface Fluid on Intraoperative OCT and Textural Interface Opacity After DSAEK Surgery in the PIONEER Study

Juthani

Goshe

Srivastava

et al. 2014

Cornea

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Purpose To examine the association between transient interface fluid (TIF) and textural interface opacity (TIO) following DSAEK surgery using intraoperative optical coherence tomography (iOCT) in the PIONEER study. Methods All consecutive eyes that underwent DSAEK between October 2011 and September 2013 from the PIONEER intraoperative and perioperative OCT study were included. iOCT images were captured after lenticule apposition with complete air fill and after air-fluid exchange. Postoperative day (POD) 1 OCT images were obtained. Outcome variables included the presence of TIO at the graft-host junction and the presence of intraoperative and postoperative interface fluid on OCT. Results Seventy-six eyes from 69 patients which underwent DSAEK with iOCT were included. The mean age was 71 years (range 31-90). The two most common indications for surgery were Fuchs’ dystrophy (63%) and pseudophakic bullous keratopathy (24%). In 18/76 (23.7%) eyes, TIF was visible on iOCT post air-fluid exchange. Of these eyes, 14 developed TIO. TIO was observed in 18/76 (23.7%) eyes. TIF on iOCT was associated with a significantly higher rate of postoperative TIO (OR=47.25; p<0.0001). Sixteen of the 18 eyes that had TIF on iOCT had had resolution on the POD 1 OCT. There was no significant difference in mean graft thickness between eyes with TIF on iOCT and those without (p=0.58). Conclusions Eyes with TIF on iOCT are more likely to develop TIO in the postoperative period. It is believed that the process of gap closure results in TIO, possibly secondary to precipitated solutes, retained viscoelastic, or lamellar irregularities caused by delayed adhesion or uneven matching of lamellar fibrils.

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“…Graft dislocation is the most frequent complication, and it tends to occur in the early postoperative period. Dislocation rates range widely with technique and surgeon experience, with studies reporting dislocation rates of 1.5 % [38]–85 % [39]. Primary graft failure is also a major cause of graft failure, and occurs in 0 % [40]–18 % [41] of grafts.…”

Section: Deep Anterior Lamellar Keratoplasty (Dalk)mentioning

confidence: 99%

Evolving Techniques in Corneal Transplantation

Boynton

Woodward

2015

Curr Surg Rep

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Corneal transplantation is one of the most common types of human transplant surgery. By removing a scarred or damaged host cornea and replacing it with a clear and healthy donor transplant, this procedure helps to restore vision in a variety of corneal diseases. The traditional technique for corneal transplantation, penetrating keratoplasty (PKP), involves transplantation of all corneal layers. Over the past decade though, there has been a trend away from PKP as surgeons have developed partial thickness transplant procedures, such as deep anterior lamellar keratoplasty and Descemet stripping automated endothelial keratoplasty. These partial thickness transplant procedures selectively replace diseased host corneal tissue, while conserving healthy and functioning tissue. This review describes current surgical techniques in the field of corneal transplantation, with special emphasis on indications for transplantation and postoperative outcomes.

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Endothelial Keratoplasty

Cited by 227 publications

References 31 publications

Descemet stripping automated endothelial keratoplasty in Fuchs′ endothelial dystrophy versus pseudophakic bullous keratopathy

Descemet stripping automated endothelial keratoplasty in Fuchs′ endothelial dystrophy versus pseudophakic bullous keratopathy

Association Between Transient Interface Fluid on Intraoperative OCT and Textural Interface Opacity After DSAEK Surgery in the PIONEER Study

Evolving Techniques in Corneal Transplantation

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