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MA Terry, PJ Ousley; Replacing the Endothelium Without Surface Corneal Incisions or Sutures: Spherical Equivalent Refractive Results in the First U.S. DLEK Patients . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4168.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Traditional penetrating keratoplasty for Fuchs' Dystrophy or PBK can result in a clear graft but unpredictable refractive results with resultant high myopia or hyperopia. Deep Lamellar Endothelial Keratoplasty (DLEK) is a new surgery designed to replace the endothelium through a limbal scleral incision, leaving the surface of the recipient cornea untouched. We evaluated the change in spherical equivalent (SE) after DLEK surgery. Methods: Twelve patients with Fuchs' received DLEK surgery. Manifest refraction SE was calculated at 6 and 12 months and compared to pre-op. Results: Average SE at 6 months was 0.06±0.98 diopters (range = -1.38 to +1.50 diopters; n=12). At 6 months, 10 of 12 patients had a SE within 1.0 diopter of pre-op. Average SE at 12 months was 0.23±1.23 diopters (range = -1.00 to +2.00 diopters; n=5). Conclusion: Early results from this first U.S. clinical trial of the DLEK procedure are encouraging. The average refractive SE results at 6 and 12 months are near plano and the full range of SE's are easily corrected with spectacles. The predictability of these results is far superior to the variation in SE found after traditional penetrating keratoplasty. DLEK surgery should allow superior accuracy in the choice of IOL power for combined procedures of endothelial replacement and cataract extraction than current full thickness triple procedures.
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