April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
12-Month Visual Outcome and Intraocular Pressure after Descemet's Stripping with Automated Endothelial Keratoplasty
Author Affiliations & Notes
  • Shabnam Khashabi
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • Pho Nguyen
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • Farnaz Memarzadeh
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • Vikas Chopra
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • Brian Francis
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • Martin Heur
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • Jonathan Song
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • Samuel Yiu
    Ophthalmology, Doheny Eye Institute, Los Angeles, California
  • Footnotes
    Commercial Relationships  Shabnam Khashabi, None; Pho Nguyen, None; Farnaz Memarzadeh, None; Vikas Chopra, None; Brian Francis, None; Martin Heur, None; Jonathan Song, None; Samuel Yiu, None
  • Footnotes
    Support  NEI Core Grant EY03040, Unrestricted Research to Prevent Blindness
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 760. doi:
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      Shabnam Khashabi, Pho Nguyen, Farnaz Memarzadeh, Vikas Chopra, Brian Francis, Martin Heur, Jonathan Song, Samuel Yiu; 12-Month Visual Outcome and Intraocular Pressure after Descemet's Stripping with Automated Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2011;52(14):760.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To compare visual outcome and intraocular pressure (IOP) after Descemet’s stripping with automated endothelial keratoplasty (DSAEK) in patients with and without glaucoma.

Methods: : Retrospective case series of 316 eyes undergoing DSAEK in 280 patients (pts). Visual acuity (VA) and IOP were recorded for pts undergoing DSAEK as performed by 4 corneal specialists at Doheny. A total of 191 pts were included and classified into non-glaucoma (C; 70), medical glaucoma (G; 78), and surgical glaucoma (GS; 43) groups.

Results: : Preop diagnoses included Fuchs’ endothelial dystrophy (FED, 22.2%), pseudophakic bullous keratopathy (PBK, 43.4%), combined FED and PBK (16.8%), and corneal decompensation from other etiologies (17.7%). Ocular comorbidities included diabetic retinopathy (8%), age-related macular degeneration (5.4%), neovascular macular degeneration (1.1%), advanced glaucoma (5%), retinal detachment (3.2%), band keratopathy (1.1%), giant cell arteritis (0.4%), and amblyopia (1.4%). At post-op month (POM) 12, mean best-corrected logMAR VA improved from 1.09 to 0.52, 1.25 to 0.61, and 1.69 to 1.08, in the C, G and GS groups, respectively, (P<0.05). Preexisting ocular comorbidities contributed to suboptimal mean VA. Mean IOP remained higher in the G group versus the C and GS groups, P<0.05. Mean IOP appeared to increase at POM 3. No significant increase was seen when comparing POM 3 to preop IOP, P>0.05; but a significant increase was observed when comparing POM 3 to postop week 1 in the C and GS groups, P<0.05, but not the G group, P>0.05. Magnitude of IOP elevation was 1.93 mmHg for C and 3.18 mmHg for GS. The percentage of pts with IOP elevation at POM 1,3,6, and 12 is 4.7%, 8.9%, 5.2% and 2.1%, respectively.

Conclusions: : 12-month data show that DSAEK provides good visual recovery in patients with FED and PBK. There is a high prevalence of IOP elevation, likely from steroid response, in this cohort. Further investigations recommended to see if pts with glaucomatous optic neuropathy require aggressive IOP management.

Keywords: cornea: endothelium • clinical (human) or epidemiologic studies: outcomes/complications • intraocular pressure 
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