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Julia Talajic, Mark Terry, Michael Straiko, Asem Alqudah, David Davis-Boozer; DSAEK: Endothelial cell loss is greater for Pseudophakic Bullous Keratopathy than for Fuchs’ Dystrophy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3091.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether Fuchs’ endothelial dystrophy eyes and postsurgical bullous keratopathy (PBK) eyes have differing rates of endothelial cell loss and longterm graft survival following Descemet’s stripping automated endothelial keratoplasty (DSAEK).
A review of 854 cases of DSAEK was performed to compare the survival rate and donor endothelial cell loss between eyes with a pre-operative diagnosis of PBK (n=106) versus that of Fuchs’endothelial dystrophy (n=748). Cell loss at 6, 12, and 24 months post-operatively was compared with student t-tests. Long-term survival was compared with Chi Square test.
The mean cell loss for Fuchs’ versus PBK was 25% versus 30% at 6 months (p=.012), 25% versus 30% at 1 year (p=.078), and 26% versus 40% at 2 years (p<0.001). 6 Fuchs’ eyes (0.8%) versus 4 PBK eyes (3.8%) experienced late endothelial failure (LEF).
Postoperative endothelial cell loss is significantly higher for eyes with PBK than those with Fuchs’ dystrophy, and LEF occurs at a higher rate among PBK patients. Possible mechanisms to explain these differences in cell loss will be discussed.
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