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F. McDonald, B. Huang, C. McCaa, L. Wigington; Descemet’s Stripping Endothelial Keratoplasty versus Penetrating Keratoplasty: Post-Operative Visual and Refractive Outcomes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4703.
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To compare pre-operative and post-operative visual acuity and refractive outcome following Descemet’s stripping endothelial keratoplasty (DSEK) and penetrating keratoplasty (PKP) in the treatment of corneal endothelial dysfunction.
A retrospective comparison was made between patients who underwent PKP and those that underwent DSEK for corneal endothelial disease. Visual acuity and refractive outcomes were compared post-operatively. For those eyes undergoing DSEK, pre-operative and post-operative endothelial cell counts were compared as well.
For those eyes undergoing PKP, pre-operative visual acuity ranged from 20/40 to hand-motion, with mean spherical equivalent 0.73±1.5 diopters (D) and mean cylinder 1.04±1.0 D. Post-operative best-corrected visual acuity, measured between 6 and 12 months after surgery, ranged from 20/30 to 20/200. Mean post-operative spherical equivalent was 2.30±4.2 D and mean post-operative cylinder was 5.77±2.7 D. Following PKP, 29% of eyes had best corrected visual acuity of 20/40 or better, and 36% improved greater than two lines of vision. For those eyes undergoing DSEK, pre-operative visual acuity ranged from 20/50 to hand-motion. Mean pre-operative spherical equivalent was 1.68±3.2 D and mean pre-operative cylinder was 1.50±1.4 D. Post-operative visual acuity ranged from 20/25 to finger-count. Post-operative mean spherical equivalent was 2.03±3.0 D and mean cylinder was 1.30±1.5 D. Following DSEK, 60% of eyes had best corrected visual acuity of 20/40 or better, and 80% improved greater than two lines of vision.
DSEK provides improved visual outcomes and significantly less corneal astigmatism when compared with PKP for the treatment of corneal endothelial dysfunction.
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