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K. K. Weller, J. D. Unterlauft, F. Grehn, G. Geerling; Relation of Trabecular Meshwork Outflow Facility, Tonometry and Corneal Thickness Following Descemet Stripping Endothelial Keratoplasty (DSEK). Invest. Ophthalmol. Vis. Sci. 2009;50(13):632.
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Increased intraocular pressure (IOP) is a frequent complication of penetrating keratoplasty and can be due to reduced trabecular meshwork outflow facility. Descemet stripping endothelial keratoplasty (DSEK) is a new lamellar technique for replacing pathological corneal endothelium and may be associated with a lower risk of postoperative IOP rise. In a prospective clinical study we studied IOP and outflow facility before and after DSEK.
In 13 eyes of 13 patients before, 1 day and 6 weeks, as well as 3, 6 and 12 months after DSEK IOP was measured using Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT). Trabecular meshwork outflow facility was assessed by impression tonography with the Schioetz tonometer. Central corneal thickness (CCT) was measured by Haag Streit Pachymeter.
IOP increased significantly from preoperatively 13.5 ± 3.3 mmHg measured with GAT (DCT: 14.7 ± 3.2 mmHg) to 16.3 ± 5.2 mmHg (DCT: 17.2 ± 4.6 mmHg) at 3 months and 15.3 ± 3.7 mmHg (DCT: 15.6 ± 4.1 mmHg) at 1 year after surgery (p=0.04). The difference between GAT and DCT was only significant at 1 year (p=0.03). Outflow facility (C-value) increased significantly from 0.20 ± 0.03 preoperatively to 0.24 ± 0,04 at 3 months (p=0.0008) and 0.28 ± 0.05 (mm3/ΔmmHg/min) at 1 year (p=0.0005) post surgery. The mean CCT decreased from 647 ± 60 µm preoperatively to 586 ± 59 µm at 1 year (p=0.04).
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