Endothelial keratoplasty versus penetrating keratoplasty for Fuchs endothelial dystrophy

Abstract

Background-Fuchs endothelial dystrophy (FED) is a condition in which there is premature degeneration of corneal endothelial cells. When the number of endothelial cells is reduced to a significant degree, fluid begins to accumulate within the cornea. As a result, the cornea loses its transparency and the individual suffers a reduction in vision. The only successful surgical treatment for this condition is replacement of part or all of the cornea with healthy tissue from a donor. The established procedure, penetrating keratoplasty (PKP), has been used for many years and its safety and efficacy are well known. Endothelial keratoplasty (EK) techniques are relatively new surgical procedures and their safety and efficacy relative to PKP are uncertain. Objectives-The objective of this review was to compare the benefits and complications related to two surgical methods (EK and PKP) of replacing the diseased endothelial layer of the cornea with a healthy layer in people with FED. Search methods-We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (

Immune Cells on the Corneal Endothelium of an Allogeneic Corneal Transplantation Rabbit Model

“…6,[15][16][17] Corneal transplantation performed as a DSEK procedure in the rabbit gave a successful graft in all cases, with a transparent cornea and no serious complications such as graft rejection, graft failure, or graft dislocation. Representative slit-lamp microscopic images showed attachment of the graft to the back side of cornea, and corneal transparency was maintained in the rabbit model 2 weeks after surgery (Fig.…”

Determinants of visual quality after endothelial keratoplasty

“…Head-to-head comparisons of PKP and EK have failed to demonstrate statistically significant differences in final BCVA outcomes. 69,86 Earlier, large series of PKP reported visual acuity of 20/40 or better in 47-65% patients treated for FED and 20-40% in patients treated for pseudophakic or aphakic bullous keratopathy, with follow-up ranging from two to eight years. 5 In contrast, 38-100% of patients undergoing manual or automated Descemet stripping endothelial keratoplasty (DSEK / DSAEK) achieve 20/40 or better across several studies.…”

“…25,86 This was attributed to interface haze and increased stray light, potentially caused by laser-activation of keratocytes, as well as irregularity of the laserdissected graft surface. 25 Refinements in graft preparation (manual and automated microkeratome techniques) and progressively thinner lenticules may reduce the role of interface irregularities in determining postoperative visual outcomes.…”

Perforierende Keratoplastik vs. „Descemet stripping automated endothelial keratoplasty“ im Partnerauge

“…Die medianen Refraktionswerte nach PK müssen allerdings im Literaturvergleich als ungewöhnlich gut betrachtet werden [6,23]. Vermutlich ist von einer besonderen Auswahl von Patienten auszugehen, die für verschiedene Operationsmethoden an beiden Augen infrage kamen.…”