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Ritika Mukhija, Tushar Agarwal, Jeewan S Titiyal, Namrata Sharma, Rajesh Sinha, Praful Kumar Maharana; Epithelial healing following Descemet’s Stripping Automated Endothelial Keratoplasty: Role of Therapeutic Contact Lens. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1312.
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© ARVO (1962-2015); The Authors (2016-present)
To study the efficacy and safety of therapeutic contact lens (TCL) in patients undergoing Descemet’s stripping automated endothelial keratoplasty (DSAEK). To study corneal epithelial healing pattern in patients undergoing DSAEK.
The study was designed as a single centre, prospective, randomized, controlled clinical trial. Forty eyes of forty patients of Pseudophakic Bullous Keratopathy undergoing DSAEK were enrolled. Patients were randomly allocated into 2 groups, control (no TCL) and test (TCL). The initial follow-up was done daily till complete re-epithelization was noted and then subsequently at 1 week, 1 month and 3 months. Primary outcome measure was time taken (in days) for epithelial healing and secondary outcome measures were post-operative pain score, graft attachment, best spectacle corrected visual acuity and endothelial cell loss at 3 months.
Average time taken for epithelial healing was 3.35 ± 0.49 days in the test group and 4.95 ± 1.05 days in the control group (P<0.001). Average post-operative pain scores were significantly lower in the test group as compared to the control group (P<0.001). Graft detachment rates were significantly higher in the control group (40%) than the test group (10%) (P=0.03) with a rebubbling rate of 15% in the control group and none in the test group (P=0.07). Average endothelial cell loss at 3 months was 18.59% in the test group and 22.09% in the control group (P=0.06). No contact lens related adverse effects were noted during the study period.
Use of a TCL in DSAEK leads to faster epithelial healing and lesser postoperative pain. In addition, graft detachment and rebubbling rates and the endothelial cell less were relatively lesser in the test group. Thus TCL should be routinely used in postoperative management of cases of DSAEK, where epithelial debridement is done.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Serial representative Spectral Domain Anterior Segment Optical Coherence Tomography photographs and respective clinical photographs showing epithelial healing in a patient in control group
Serial representative Spectral Domain Anterior Segment Optical Coherence Tomography photographs showing epithelial healing in a patient in test group
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