Comparison of outcomes of penetrating keratoplasty versus Descemet's stripping automated endothelial keratoplasty for penetrating keratoplasty graft failure due to corneal edema

Anna S Kitzmann; George R Wandling; John E Sutphin; Kenneth M Goins; Michael D Wagoner

doi:10.1007/s10792-012-9518-4

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Comparison of outcomes of penetrating keratoplasty versus Descemet's stripping automated endothelial keratoplasty for penetrating keratoplasty graft failure due to corneal edema

Journal article

Peer reviewed

Comparison of outcomes of penetrating keratoplasty versus Descemet's stripping automated endothelial keratoplasty for penetrating keratoplasty graft failure due to corneal edema

Anna S Kitzmann, George R Wandling, John E Sutphin, Kenneth M Goins and Michael D Wagoner

International ophthalmology, Vol.32(1), pp.15-23

02/2012

DOI: 10.1007/s10792-012-9518-4

PMID: 22271071

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Abstract

To evaluate the outcomes of repeat corneal transplantation, either penetrating keratoplasty (PKP) or Descemet's stripping automated endothelial keratoplasty (DSAEK), for penetrating keratoplasty grafts which failed due to corneal edema. The charts of 24 eyes with failed PKP grafts, due to corneal edema, which underwent a repeat corneal transplant (PKP in 17 eyes [Group 1] and DSAEK in seven eyes [Group 2]) between 2003 and 2007 were retrospectively reviewed. There was no statistically significant difference in the median postoperative visual acuity between the two groups at 1, 2, or 3 years. In Group 1, two (18%) eyes had a final visual acuity ≥ 20/40, in contrast to four (80%) eyes in Group 2, which was statistically significant (P = 0.038). Seven (41%) of the Group 1 eyes developed postoperative complications compared to only one (14%) eye in Group 2. Eleven (65%) of the Group 1 eyes and five (71%) of Group 2 eyes had clear grafts on the last examination. There was no statistically significant difference in the graft survival rate for Group 1 versus Group 2 at 3 years (57.9% vs 68.6%, P = 0.507). There was a trend towards better postoperative visual acuity, a lower postoperative complication rate, and a higher graft survival rate in eyes that underwent DSAEK rather than repeat PKP for graft failure secondary to corneal edema. Given this small, retrospective study, future studies comparing repeat PKP with DSAEK are warranted to determine which procedure allows for improved outcomes.

Descemet Stripping Endothelial Keratoplasty

Prognosis

Follow-Up Studies

Humans

Middle Aged

Male

Corneal Edema - surgery

Incidence

Graft Rejection - epidemiology

Reoperation - methods

Treatment Failure

Keratoplasty, Penetrating

Aged, 80 and over

Adult

Female

Iowa - epidemiology

Retrospective Studies

Postoperative Complications

Risk Factors

Corneal Edema - complications

Graft Rejection - etiology

Graft Survival

Visual Acuity

Graft Rejection - surgery

Aged

Details

Title: Subtitle: Comparison of outcomes of penetrating keratoplasty versus Descemet's stripping automated endothelial keratoplasty for penetrating keratoplasty graft failure due to corneal edema
Creators: Anna S Kitzmann - Department of Ophthalmology and Visual Sciences, University of Iowa Hospital and Clinics, University of Iowa Carver College of Medicine, Pomerantz Family Pavilion, 200 Hawkins Drive, Iowa City, IA 52242-1091, USA. anna-kitzmann@uiowa.edu
George R Wandling
John E Sutphin
Kenneth M Goins
Michael D Wagoner
Resource Type: Journal article
Publication Details: International ophthalmology, Vol.32(1), pp.15-23
Publisher: Netherlands
DOI: 10.1007/s10792-012-9518-4
PMID: 22271071
ISSN: 0165-5701
eISSN: 1573-2630
Language: English
Date published: 02/2012
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983979984202771

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