Document Detail


Descemet stripping and automated endothelial keratoplasty (DSAEK) in eyes with failed penetrating keratoplasty.
MedLine Citation:
PMID:  17592318     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report our results of using Descemet stripping and automated endothelial keratoplasty (DSAEK) in eyes with failed penetrating keratoplasty (PK). METHODS: An institutional review board-approved, prospective, surgical case series of 7 eyes of 7 consecutive patients undergoing DSAEK for graft failure after 1 or more PKs at 1 academic eye center. RESULTS: The mean follow-up period was 13.3 months (range, 9-18 months). One eye suffered recurrent donor graft dislocation and elected to undergo repeat PK instead of repeat DSAEK. Of the remaining 6 patients, the average preoperative visual acuity (VA) was 20/851 compared with a best-corrected visual acuity (BCVA) of 20/65 postoperatively (P = 0.008). After DSAEK, 6 (100%) eyes showed improved BCVA, and 4 of 6 eyes (67%) achieved a BCVA of 20/40 or better. All 6 grafts remained clear at the last follow-up visit. Two eyes showed graft dislocation on the first postoperative day and underwent repositioning of the lenticule with good results. Two other eyes were diagnosed with primary iatrogenic graft failure within 1 week of DSAEK and underwent repeat DSAEK with new donor tissue with good results. One eye experienced acute graft rejection that was successfully treated with topical steroids. CONCLUSIONS: This pilot series of DSAEK in eyes with graft failure from previous PK shows favorable VA and graft clarity outcomes. The complications observed were similar to those observed for DSAEK for Fuchs dystrophy and pseudophakic bullous keratopathy and include graft dislocation, iatrogenic graft failure, and homograft rejection.
Authors:
Douglas J Covert; Steven B Koenig
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cornea     Volume:  26     ISSN:  0277-3740     ISO Abbreviation:  Cornea     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-26     Completed Date:  2007-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  692-6     Citation Subset:  IM    
Affiliation:
The Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Corneal Transplantation / methods*
Descemet Membrane / surgery*
Endothelium, Corneal / transplantation*
Female
Follow-Up Studies
Graft Rejection / surgery
Humans
Keratoplasty, Penetrating*
Male
Middle Aged
Pilot Projects
Prospective Studies
Reoperation
Treatment Failure
Treatment Outcome
Visual Acuity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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