July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Outcomes of complex Descemet's stripping automated endothelial keratoplasty (DSAEK) in eyes with significant ocular comorbidities
Author Affiliations & Notes
  • Kevin K Ma
    Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
  • Yvonne Wang
    Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
  • Nayan Sanjiv
    Boston University School of Medicine, Boston, Massachusetts, United States
  • Ula V Jurkunas
    Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
  • Jia Yin
    Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Kevin Ma, None; Yvonne Wang, None; Nayan Sanjiv, None; Ula Jurkunas, None; Jia Yin, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6283. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Kevin K Ma, Yvonne Wang, Nayan Sanjiv, Ula V Jurkunas, Jia Yin; Outcomes of complex Descemet's stripping automated endothelial keratoplasty (DSAEK) in eyes with significant ocular comorbidities. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6283.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : While outcomes from routine uncomplicated DSAEK have been reported extensively in the literature, those from complex eyes have not been reported in a large series. We aim to report the outcomes of DSAEK in such eyes to better understand the role of ocular comorbidities, operative techniques, and post-operative management on outcomes.

Methods : This is a retrospective study of 36 consecutive cases of DSAEK procedures on eyes with significant co-morbidities conducted by a single surgeon between January 2014 and June 2017. We analyzed the ocular history, indications for surgery, intraoperative surgical techniques, post-operative complications, and outcomes.

Results : 36 eyes of 35 patients (15 men and 20 women; mean 68.4 ± 13.0 years old) were included. The mean follow-up period was 19.4 ± 9.8 months. All eyes had significant ocular co-morbidities (glaucoma, complicated cataract surgery, aqueous misdirection, uveitis, open globe injury, retinal detachment, and others). Prior ocular surgery included corneal surgery (53%), glaucoma surgery (56%), and vitrectomy (19%). Surgical indications included secondary corneal decompensation following ocular surgery (58%) and failure of prior corneal graft or endothelial keratoplasty (42%). Nearly half (44%) of the cases had a concurrent procedure and two-thirds (67%) of the cases used anchoring sutures. Mean pre-operative best-corrected visual acuity (logMAR) was 1.75, which improved to 1.05 at last follow-up visit (Wilcoxon matched pair test P=0.0034). Post-operative complications included re-bubbling (39%), re-suturing (14%), primary graft failure (8%), and secondary graft failure (19%). Graft survival was 82% at 12-month follow-up and 73% at 2-year follow-up.

Conclusions : Compared to uncomplicated DSAEK, complex DSAEK in eyes with significant ocular comorbidities have higher post-operative complication and lower graft survival rates. Despite these findings, DSAEK remains a viable treatment option for corneal decompensation and visual rehabilitation in these eyes with significant ocular comorbidities.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×