Abstract
Purpose:
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).
Methods:
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.
Results:
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).
Conclusions:
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.
Keywords: 481 cornea: endothelium •
741 transplantation •
449 cell survival