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G. W. Thompson, A. V. Spigelman; Clinical and Subjective Outcomes of Penetrating Keratoplasty vs. DSAEK in Fellow Eyes. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1941.
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To compare subjective and objective visual outcomes from patients who had DSAEK and PK in fellow eyes.
DSAEK has been adopted as a form of visual rehabilitation for patients with endothelial dystrophies, especially Fuchs' Dystrophy. Prior to the advent of DSAEK, these patients underwent traditional penetrating keratoplasties. The transition period has presented seven patients who underwent PK initially, and then DSAEK subsequently in the fellow eye. All surgeries were performed by a single surgeon (AVS). Data was collected on post-operative astigmatism and vision. A survey was distributed to evaluate visual and surgical recovery after surgery; as well as, patient’s surgical preference.
Post-operative values for average residual astigmatism were lower in the DSAEK eye compared to the PK eye by 2 diopters on manifest refraction and 7 diopters on keratometry. Post-operative average visual acuity was better in the DSAEK eye as compared to the PK eye (logMAR .31 vs .43). On a subjective questionnaire, three patients reported visual acuity at 6 months to be better in the DSAEK eye, and four patients reported similar vision; no patients reported better vision in the PK eye. Additionally five of the seven patients reported more rapid recovery in the DSAEK eye; the other two patients reported the same speed of recovery for both eyes. Overall six of seven patients preferred the vision in their DSAEK eye, and one preferred the vision in the PK eye. Furthermore five of seven patients preferred the post-operative course of the DSAEK eye, one preferred the PK eye, and one noted a similar course with both surgeries.
DSAEK is an excellent option for cornea transplant with less post-operative astigmatism and improved visual acuity compared to PK. Visual and surgical recovery was quicker in DSAEK eyes than PK eyes. Finally, patients preferred the vision and post-operative course of their DSAEK eye to their PK eye.
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