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M. A. Terry, N. Shamie, P. Phillips, E. S. Chen, K. L. Hoar, H. A. Saad, D. J. Friend; Endothelial Keratoplasty: Are Post-Op Results and Complications Different With Fuchs’ Dystrophy Eyes Than With Non-Fuchs Eyes?. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2322.
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Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) can be used to treat the corneal edema resulting from Fuchs’ or from non-Fuchs causes. Are the results and/or complications different in these two groups?
DSAEK was performed in 186 eyes with Fuchs’ (F) (n=159) or non-Fuchs’ (NF) (n=27) corneal edema. Vision (Va), pachymetry (pachy) and Endo cell density (ECD) were recorded prospectively at pre-op and 6 months post op. The incidence of retinal co-morbidity (CME, AMD, etc), dislocation and primary graft failure was also documented for each group.
Pre-op mean Va was 20/67 in F group and 20/222 in NF (p=.01) and post-op Va was 20/33 in F and 20/63 in NF (p=.01). Pre-op pachy was 677 um in F and 783 um in NF. (p=.01) and post-op pachy was 657 um in F and 669 um in NF. (p=.282) ECD decreased 33% in F and 35% in NF (p=.63). Retinal co-morbidity was present in only 30% of F eyes, but in 52% of NF eyes. (p=.023) There were only 4 dislocations in the entire series (2% dislocation rate) and all occurred in the F group. There were no primary graft failures in either group. (0% primary graft failure rate)
DSAEK surgery is safe and effective in the treatment of corneal edema for Fuchs’ eyes and non-Fuchs’ eyes utilizing our specific surgical technique. NF eyes have worse pre-op and post-op vision than F eyes, but this likely is due to the higher incidence of co-existent macular disease and worse pre-operative corneal edema with worse recipient residual anterior stromal haze. ECD loss and complications were not different between the groups.
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