Endothelial Keratoplasty for Fuchs' Dystrophy with Cataract

Terry, Mark A.; Shamie, Neda; Chen, Edwin S.; Phillips, Paul; Shah, Anand K.; Hoar, Karen L.; Friend, Daniel J.

doi:10.1016/j.ophtha.2008.11.004

Cited by 189 publications

(53 citation statements)

References 28 publications

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“…[3536373839404142434445464748495051525354555657585960616263646566676869707172] Figs. 1 and 2 show the postoperative outcomes after DSAEK and ultrathin DSAEK, respectively.…”

Section: Outcomes Of Descemet Stripping Automated Endothelial Keratopmentioning

confidence: 99%

Descemet stripping automated endothelial keratoplasty

Sharma

Maharana

Singhi

et al. 2017

Indian J Ophthalmol

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Endothelial keratoplasty is at present the gold standard for surgical treatment of corneal endothelial pathologies not associated with significant corneal scar. Tremendous progress has been made in recent years in improving the technology of endothelial keratoplasty techniques, such as descemet stripping automated endothelial keratoplasty (DSAEK) and descemet membrane endothelial keratoplasty. In this review, we discuss the current techniques and outcomes of DSAEK.

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“…[3536373839404142434445464748495051525354555657585960616263646566676869707172] Figs. 1 and 2 show the postoperative outcomes after DSAEK and ultrathin DSAEK, respectively.…”

Section: Outcomes Of Descemet Stripping Automated Endothelial Keratopmentioning

confidence: 99%

Descemet stripping automated endothelial keratoplasty

Sharma

Maharana

Singhi

et al. 2017

Indian J Ophthalmol

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“…This target refraction was also adopted by many surgeons and described in the literature. [142425] Despite this approach, however, a hyperopia of up to +4.0 D was observed in this group. There are two approaches to improve refractive outcomes after the DSAEK triple procedure including aiming for a more myopic postoperative outcome by targeting a postoperative refraction of −1.0 to −2.0 D and optimization of the IOL constant.…”

Section: Discussionmentioning

confidence: 73%

“…Although some previous studies advocated that cataract surgery and subsequent endothelial keratoplasty should be performed as a 2-stage surgical procedure,[13] the current predominating opinion suggests that both procedures can be carried out at the same time. [1415] Terry et al[14] suggested that combined DSAEK and phacoemulsification procedure did not significantly differ in terms of clinical outcomes. This observation indicates that concurrent phacoemulsification and posterior chamber IOL implantation does not negatively impact postoperative visual acuity.…”

Section: Discussionmentioning

confidence: 99%

“…There are two approaches to improve refractive outcomes after the DSAEK triple procedure including aiming for a more myopic postoperative outcome by targeting a postoperative refraction of −1.0 to −2.0 D and optimization of the IOL constant. [1142526] However, unacceptable refractive outcomes should be expected in patients who undergo DSAEK triple procedures. The four potential sources of error in IOL calculations are corneal curvature measurement, axial length measurement, effective lens position estimation, and the IOL calculation formula.…”

Section: Discussionmentioning

confidence: 99%

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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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“…Technically, it is more difficult and more time-consuming than PK, but in particular cases, better anatomical and functional (visual acuity) results are achieved [47–51,58,59]. Lamellar keratoplasty has become an alternative method to PK as a result of the following factors: it is a causative therapy (selective stroma or endothelium transplantation); it prevents complications resulting from an “open sky” technique and immunization; it optimizes refraction effects; it improves recovery conditions, including healing time; and it uses the donor’s tissues economically (1 cornea for the anterior/posterior transplants in 2 recipients) [47,49,51,60]. …”

Section: Corneal Lamellar Graftsmentioning

confidence: 99%

Ophthalmic transplantology: Anterior segment of the eye – Part I

Nita¹,

Strzałka‐Mrozik

Grzybowski

et al. 2012

Med Sci Monit

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SummaryBackgroundTransplantology is a quickly developing field of ophthalmology. It currently is able to treat many inherited, degenerative, inflammatory, traumatic, and cancerous diseases. This review outlines recent concepts and methods of treating ocular diseases with tissue and cell grafts. Ocular transplants related to the anterior part of the eye, including the conjunctiva and the cornea, are reviewed in Part 1.Material/MethodsThe scientific literature dated from January 2005 to July 2011 was thoroughly searched using Medline and PubMed. Publications dated 2009, 2010, and 2011 were analyzed in detail. Search terms were as follows: auto-, homo-, heterologous transplantation, eyeball, ocular adnexa, anterior segment of the eye, cornea, lamellar keratoplasty, stem cells, cultured cells. Further data were found at the website of the Eye Bank Association of America.ResultsNearly all tissues of the anterior segment of the eye (the conjunctiva, sclera, eye muscles, and cornea) are transplanted. Because of the recent significant progress in the field, cornea transplantation was analyzed in more detail, specifically procedures such as limbus grafts and anterior and posterior lamellar keratoplasty. Indications, advantages, and drawbacks of the transplant techniques were also reviewed.ConclusionsRecent progress in the field of cornea transplants allows treatment at the level of the endothelium and the use of cultured limbal epithelial stem cell grafts. However, compared with previous techniques, modern and multilayered transplant techniques of the cornea require much more expertise and longer training of the surgeon, as well as expensive and technologically advanced equipment. The availability of donor tissue is still the main limitation affecting all transplants. Therefore, cell culturing techniques such as stem cells, as well as artificial cornea projects, seem to be very promising.

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Endothelial Keratoplasty for Fuchs' Dystrophy with Cataract

Cited by 189 publications

References 28 publications

Descemet stripping automated endothelial keratoplasty

Descemet stripping automated endothelial keratoplasty

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

Ophthalmic transplantology: Anterior segment of the eye – Part I

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