April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Recipient Risk Factors for Complications after Descemet Stripping with Endothelial Keratoplasty
Author Affiliations & Notes
  • Pho Nguyen
    Ophthalmology, Doheny Eye Institute - USC, Los Angeles, California
  • Shabnam Khashabi
    Ophthalmology, Doheny Eye Institute - USC, Los Angeles, California
  • Farnaz Memarzadeh
    Ophthalmology, Doheny Eye Institute - USC, Los Angeles, California
  • Vikas Chopra
    Ophthalmology, Doheny Eye Institute - USC, Los Angeles, California
  • Brian A. Francis
    Ophthalmology, Doheny Eye Institute - USC, Los Angeles, California
  • Martin Heur
    Ophthalmology, Doheny Eye Institute - USC, Los Angeles, California
  • Jonathan C. Song
    Ophthalmology, Doheny Eye Institute - USC, Los Angeles, California
  • Samuel C. Yiu
    Ophthalmology, Doheny Eye Institute - USC, Los Angeles, California
  • Footnotes
    Commercial Relationships  Pho Nguyen, None; Shabnam Khashabi, None; Farnaz Memarzadeh, None; Vikas Chopra, None; Brian A. Francis, None; Martin Heur, None; Jonathan C. Song, None; Samuel C. Yiu, None
  • Footnotes
    Support  NEI Core Grant EY03040. Unrestricted Grant from Research to Prevent Blindness.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 777. doi:https://doi.org/
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      Pho Nguyen, Shabnam Khashabi, Farnaz Memarzadeh, Vikas Chopra, Brian A. Francis, Martin Heur, Jonathan C. Song, Samuel C. Yiu; Recipient Risk Factors for Complications after Descemet Stripping with Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2011;52(14):777. doi: https://doi.org/.

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

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Abstract

Purpose: : (1) To compare the rate of complications after Descemet stripping with automated endothelial keratoplasty (DSAEK) in patients with no glaucoma and glaucoma. (2) To identify risk factors for postoperative complications.

Results: : Preoperative 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%). 40% had preexisting glaucoma and 56.3% of those received glaucoma surgery. Five-year overall complication rates were: detachment (13.3%), graft failure (16.1%), pupillary block (2.8%) and IOP elevation (21.9%). Preoperative etiologies of corneal edema were not associated with increased risk of graft detachment, pupillary block, or IOP elevation (p > 0.05). FED had a lower RR of graft failure compared to the other groups, 0.382 [0.16 - 0.93], p = 0.023. Pupillary block and IOP elevation were not related with any group. Graft detachment and IOP elevation were two independent risk factors for graft failure, with detachment a more significant contributor. Coexisting glaucoma significantly increased risk of graft failure. Glaucoma had higher risk of graft failure compared to non-glaucoma, RR = 2.61, 95% CI 1.56. History of glaucoma surgery conferred a higher risk compared to glaucoma only on drops (RR = 2.07, 95% CI [1.05 - 4.08], p = 0.045).

Conclusions: : DSAEK has emerged as the preferred treatment for corneal endothelial dystrophy. In this series of 316 cases over five year, pseudophakia / aphakia, coexisting glaucoma, history of glaucoma surgery, postoperative graft detachment or detachment, and postoperative IOP elevation were identified as risk factors for graft failure.

Keywords: cornea: endothelium • cornea: clinical science • transplantation 
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