Abstract
Abstract: :
Purpose: The Deep Lamellar Endothelial Keratoplasty (DLEK) transplant technique has been shown to provide excellent results at one year after surgery in patients with Fuchs’ dystrophy. We investigated whether the visual, topographic, and endothelial cell count results remain stable up to two years after surgery. Methods: Vision by manifest refraction (M.R.), topography by TMS–1, and endothelial cell counts by specular microscopy were prospectively measured in 17 patients with Fuchs’ dystrophy who had received DLEK surgery. Stability of results from one year to two years post–op was evaluated. Results: At 1 year post–op, BSCVA averaged 20/51 (range 20/25 to 20/200), spherical equivalents averaged –0.31 + 1.51 D, M.R. astigmatism averaged 2.09 + 1.09 D (range 0 to 4 D), mean curvature was 43.4 + 1.8 D, the SRI averaged 1.22 + 0.42, the SAI averaged 1.10 + 1.18, and the endothelial cell counts averaged 2,342 + 456 cells/mm2 (range 1,144 to 3,048). At 2 years post–op, BSCVA averaged 20/50 (range 20/25 to 20/200), spherical equivalents averaged –0.38 + 1.34 D, M.R. astigmatism averaged 1.85 + 0.66 D (range 0.75 to 3 D), mean curvature was 44.0 + 1.5 D, the SRI averaged 1.17 + 0.45, the SAI averaged 0.82 + 0.62, and the endothelial cell counts averaged 2,163 + 490 cells/mm2 (range 730 to 2,871). There was no significant difference between 1 year and 2 years for any parameter evaluated (P>0.05). Conclusions: DLEK provides very stable refractions, corneal topography, and endothelial cell densities as long as two years after surgery. The absence of corneal sutures in this technique prevents the sutures in/sutures out changes in spherical equivalent refraction and corneal topography often seen after penetrating keratoplasty (PK). DLEK, therefore, is an excellent alternative to PK in patients with endothelial dystrophies.
Keywords: transplantation • topography