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Gina M. Rogers; Visual Recovery after DSAEK. Invest. Ophthalmol. Vis. Sci. 2011;52(14):781.
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To determine the time and course to visual recovery after DSAEK (Descemets stripping automated keratoplasty) in the treatment of pseudophakic corneal edema. Additionally to determine if any correlation could be determined on the basis of different preoperative, intra-operative, and post-operative as well as donor variables on the course of visual recovery after endothelial transplantation.
A retrospective chart review was performed on the keratoplasty surgical cases of the corneal service at the University of Iowa from 2005-2007. The only cases included in this study were eyes with pseudophakic corneal edema undergoing going primary DSAEK (Descemets Stripping Automated Endothelial Keratoplasty). Cases managed by full thickness penetrating keratoplasty or DLEK were excluded. Also excluded were subjects that were phakic, aphakic or had an anterior chamber intraocular lens. Multiple variables were analyzed and divided into pre-operative, operative, post-operative and donor factors. The primary outcome measure was time versus visual recovery. Additionally, correlation between the studied variables and the time to visual recovery were determined.
78 cases met inclusion criteria. Follow-up ranged from 1 to 58 months. Vision improved quickly in the post-operative period, with the majority of cases attaining best acuity by post-operative month 3. Additionally, a high percentage of the subjects maintained stable vision without minimal fluctuation in refractive status through the duration of the study period.
There are statistically significant correlation between specific pre-operative, operative, and post-operative factors. We found a statistically signifcant escalation in medically managed glaucoma, bu not in surgical glaucoma. Surgical complications and post-operative lenticule detachements are potential factors in delay or decreased visual recovery.
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