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B. S. Lee, W. J. Stark, J. D. Gottsch, A. S. Jun; Descemet-Stripping Endothelial Keratoplasty Following Penetrating Keratoplasty at a Tertiary Care Center. Invest. Ophthalmol. Vis. Sci. 2010;51(13):741.
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© ARVO (1962-2015); The Authors (2016-present)
Examine outcomes of Descemet-Stripping Endothelial Keratoplasty(DSEK) in eyes that have had prior Penetrating Keratoplasty(PK)
Retrospective review of DSEK after PK cases from 2006-9 at atertiary care center. The outcome measures are visual acuitysix months post-operatively (expressed in logMAR) and changein visual acuity at six months.
Visual acuity improved in 6 of the 8 patients who underwentDSEK after PK. The average pre-operative visual acuity was logMAR1.375, or a Snellen acuity slightly worse than 20/400. Six monthspost-operatively, the average visual acuity was logMAR 1.0625,or a Snellen acuity of slightly worse than 20/200. The averageimprovement was logMAR 0.3, a two-fold improvement in the minimumangle of resolution.
Based on this case series, DSEK after PK is a safe and effectiveprocedure. Two patients did not have improvement of visual acuity.Patient 1 required two repositionings of the DSEK graft. Heinitially returned to his pre-operative acuity then declined,although he has not reached post-operative month #6. Patient6 was the only patient who received SF6 gas--the plain air bubblerepeatedly moved posteriorly, elevating IOP. This patient'sDSEK graft never cleared post-operatively, and she also hadvitreous hemorrhage. Her history was notable for CSME in botheyes and proliferative disease in the non-operative eye. Shewas also one of the earliest DSEKs done at the Institute. ExcludingPatient #6 resulted in a final average acuity of logMAR 0.55(Snellen 20/70). This was an average improvement in acuity oflogMAR 0.94, nearly a 10-fold improvement in minimum angle ofresolution.
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