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P.J. Ousley, M.A. Terry; Vision and Corneal Topography Results One Year After Deep Lamellar Endothelial Keratoplasty (DLEK) Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4684.
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Purpose: Deep Lamellar Endothelial Keratoplasty (DLEK) replaces diseased corneal endothelium through a limbal scleral incision, leaving the surface of the recipient cornea untouched. We evaluated the visual and topographic results one year after DLEK surgery. Methods: Vision by manifest refraction (M.R.), endothelial cell counts by specular microscopy, and topography by TMS-1 were prospectively measured in 18 patients with Fuchs' dystrophy who had received DLEK surgery. Results at one year post-op were analyzed. Results: Average best spectacle-corrected visual acuity was 20/51 (range 20/25 to 20/200) and average spherical equivalents (SE) were -0.44 + 1.57 D (range -3.75 to 2.00 D). Endothelial cell counts averaged 2,171 + 572 cells/mm2. Average M.R. astigmatism was 2.07 + 1.06 D (range 0.0 to 4.0 D). Mean curvature was 43.5 + 1.7 D and the SRI and SAI were 1.23 + 0.41 and 1.07 + 1.15, respectively. Average values for M.R. astigmatism, SE, and mean curvature at one year were not significantly different from the preoperative values. All grafts were clear at one year. Conclusions: The patients in this series experienced very good visual results and excellent endothelial cell numbers one year after DLEK. The corneal topography after DLEK was relatively unchanged from pre-op. Average SE was near plano and the full range of SE's were easily corrected with spectacles. The average astigmatism was lower and the corneal surface more regular than often seen after penetrating keratoplasty. These results suggest DLEK is an excellent alternative to penetrating keratoplasty for patients with endothelial dysfunction.
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