Abstract
Abstract: :
Purpose: To evaluate the visual, topographic, and endothelial cell count results at 6– and 12–months after Deep Lamellar Endothelial Keratoplasty (DLEK) transplant surgery combined with cataract surgery. Methods:Vision, topography, and endothelial cell counts were prospectively measured in patients with Fuchs’ dystrophy or bullous keratopathy who had received DLEK surgery. Results at 6– and 12–months post–op were statistically compared to each other and to the pre–op values. Results: 45 patients were evaluated: all 45 had 6 months follow–up and 31 of the 45 had 12 months follow–up. Best–corrected visual acuity (BSCVA) averaged 20/67 at pre–op, 20/40 at 6 months and 20/39 at 12 months. Mean corneal curvature averaged 43.8+1.3 D at pre–op, 43.4+1.2 D at 6 months, and 43.5+1.2 D at 12 months. Topographic astigmatism averaged 2.2+2.3 D at pre–op, 1.1+0.8 D at 6 months, and 1.2+1.1 D at 12 months. The surface regularity index (SRI) averaged 1.46+0.69 at pre–op, 0.99+0.35 at 6 months, and 0.95+0.39 at 12 months. The surface asymmetry index (SAI) averaged 1.43+1.12 at pre–op, 0.76+0.68 at 6 months, and 0.70+0.55 at 12 months. Spherical equivalents averaged +0.58+2.67 D at pre–op, –0.50+1.23 D at 6 months, and –0.50+1.20 D at 12 months. Endothelial cell counts averaged 2864+275 cells/mm2 in the pre–op donor tissue. Cell counts averaged 2126+429 at 6 months and 2092+415 at 12 months, reflecting an average 26% and 27% decrease in cell count from pre–op, respectively. All measurements at 6 and 12 months were significantly different from pre–op values (P<0.05). There was no significant difference between 6 months and 12 months for any parameter evaluated (P>0.05). Conclusions: Vision and corneal topography significantly improved in patients after DLEK combined with cataract surgery and remained stable from 6 months to 12 months. Endothelial cell counts remained high at 6 and 12 months and the trend toward slight myopia after surgery was as intended when IOL powers were chosen preoperatively. DLEK combined with cataract surgery, therefore, appears to be an effective treatment for patients with endothelial dystrophies.
Keywords: transplantation • cornea: clinical science • anterior segment