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M. A. Terry, N. Shamie, E. Chen, D. Friend; Endothelial Keratoplasty: Is DSAEK With Phacoemulsification Any Riskier Than DSAEK Alone?. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1132. doi: https://doi.org/.
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There is debate among transplant surgeons on the risks of doing DSAEK surgery combined with cataract surgery with a fear of increasing the dislocation rate when viscoelastic is used during phaco or damaging the donor endothelium from a newly placed, possibly unstable IOL. We compared results of DSAEK without phaco and DSAEK with phaco to determine relative risks with each procedure.
In our first consecutive 142 DSAEK cases, 96 eyes received DSAEK alone (Group 1) and 46 eyes received DSAEK with phaco (Group 2). The dislocation rate and 6 month endothelial cell density (ECD) were compared between groups.
There was one dislocation in each group. At 6 months, Group 1 had a mean ECD cell loss of 33%+/-14% and Group 2 of 37% +/- 15%, with no significant difference between the two groups. (p=.36).
Combining cataract surgery with DSAEK in the new "triple procedure" does not increase the risk of dislocation, nor does it increase measured endothelial cell loss at 6 months compared to DSAEK surgery alone.
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