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Jennifer Wai-Yin Lee, Joseph Panarelli; Outcomes of Descemet stripping automated endothelial keratoplasty performed by residents. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1569.
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Descemet stripping automated endothelial keratoplasty (DSAEK) has continued to gain popularity as an alternative to penetrating keratoplasty (PK) for the treatment of patients with endothelial cell disorders. While studies have documented the learning curve of cornea surgeons in performing DSAEK, there is little known on the similarities and differences of outcomes and complications when performed by residents in training. The purpose of our study is to evaluate the postoperative outcomes of DSAEK by residents under the supervision of experienced cornea surgeons.
We performed a retrospective chart review on patients who had DSAEK performed by residents at The New York Eye and Ear Infirmary from 2009-2013. Information recorded from the medical records included: patient demographics, preoperative diagnosis, previous ophthalmic surgical procedures, preoperative and postoperative visual acuity, postoperative refraction, preoperative and postoperative central corneal thickness, and postoperative complications.
There were a total of 33 eyes of 31 patients included in this study. The average length of follow-up was 11.6 months (range: 1 to 24 months). Indications for surgery included: pseudophakic bullous keratopathy in 23 eyes (73%), Fuchs’ endothelial dystrophy in 6 eyes (12%), and previous keratoplasty failure in 4 eyes (12%). Over 50% of the patients achieved a best corrected visual acuity of 20/60 or better at most recent follow-up with patients on average achieving three lines of visual improvement. Lenticle dislocation occurred in 12% of cases. Other serious complications occurred in less than 1% of cases and included primary graft failure, malignant glaucoma, and pupillary block.
In this study, visual outcomes and complication rates of DSAEK performed by residents with experienced cornea surgeons at an academic center were at a level comparable to those reported in the literature.
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