Purchase this article with an account.
O. Krad, C. Garcia, J. Filippelli, R. Momi, J. Paik, R. Feder, C. Bouchard, A. Lin; Retrospective Comparison of Visual Outcomes of Staged versus Simultaneous Cataract Extraction With Intraocular Lens Placement Followed by Descemet's-Stripping Automated Endothelial Keratoplasty (DSAEK). Invest. Ophthalmol. Vis. Sci. 2010;51(13):5416.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To date the authors are unaware of any statistically significant studies comparing the visual outcomes of patients undergoing staged versus combined cataract extraction with intraocular lens placement (CEIOL) and descemet’s stripping automated endothelial keratoplasty (DSAEK). Combined surgeries may enable the patient to undergo a single surgery with an overall shorter recovery time.
Retrospective chart review was carried out for patients identified to have surgery for both cataracts and Fuchs' endothelial dystrophy. The multi-center study included review of 56 eyes that underwent the staged CEIOL followed by DSAEK (group 1) and 17 eyes that underwent a combined CEIOL and DSAEK surgery (group 2).
A repeated measures one way analysis of variance for both simultaneous and staged treatment groups was statistically significant (p < 0.001). In the presence of significance for the omnibus ANOVA test, a Tukey multiple comparison test was used to perform pairwise comparisons. A statistically significant improvement in visual acuity was found between the paired preoperative and month 12 follow-up time points for both simultaneous and staged treatment groups (p < 0.05). Mean Snellen preoperative and month 12 measures of visual acuity for simultaneous and staged groups ranged from 20/50 to 20/30 and 20/100 to 20/47 respectively (LogMAR conversion). These values represent an overall improvement in visual acuity of 49.3% and 46.7% for simultaneous and staged procedures respectively.
Thus far, analysis of the data indicates that improvements of visual acuity in patients who underwent combined CEIOL and DSAEK surgeries are at least as good as patients who underwent staged surgeries. However, the preoperative visual acuities in the two groups were significantly different than each other. Also, the number of patients who underwent combined procedures was significantly lower than the number of patients who underwent staged procedures. Trends are being studied further to indicate which surgical protocol has better visual outcomes and fewer post-operative complications.
This PDF is available to Subscribers Only