Journal article
Visual Acuity, Refractive Error, and Endothelial Cell Density 6 and 12 Months After Deep Lamellar Endothelial Keratoplasty
Cornea, Vol.29(6), pp.601-606
06/01/2010
DOI: 10.1097/ICO.0b013e3181c11de4
PMID: 20458237
Abstract
Purpose: To report the visual acuity, refractive outcome, and endothelial cell density (ECD) up to 1 year after deep lamellar endothelial keratoplasty (DLEK) in a large prospective series.
Methods: Eighty-six DLEK procedures were performed and evaluated in a prospective interventional case series. Subgroup analysis was performed to compare results from large-incision (9 mm) DLEK (n = 7), small-incision (5-8 mm) DLEK (n = 70), and penetrating keratoplasty (MP) conversion (n = 9). Outcome measures included best-corrected visual acuity (BCVA), manifest refraction, corneal topographic astigmatism, and ECD.
Results: The percentage of eyes that achieved a BCVA of 20/40 or better after DLEK was 55% at 6 months, increasing to 61% at 1 year. Topographic astigmatism and spherical equivalent were not significantly different than preoperative measurements up to 1 year after DLEK (P > 0.05). An endothelial cell loss of 40% at 6 months and 48% by 1 year was observed. The mean ECD after DLEK was 1831 +/- 472 cells per square millimeter at 6 months and 1569 +/- 601 cells per square millimeter at 12 months. When evaluated by incision size, the ECD was better at 2066 +/- 558 cells per square millimeter with a 9-mm incision compared with only 1516 +/- 585 cells per square millimeter with a smaller incision at 1 year, although this did not reach significance (P = 0.075). The endothelial cell loss after penetrating keratoplasty conversion was similar to that in the large-incision group (P > 0.05).
Conclusions: DLEK provides good visual acuity (>= 20/40) for the majority of patients at 1 year with stable refractive error compared with baseline. Refractive stability was observed with both large- and small-incision DLEKs; however, worrisome endothelial cell loss was observed, especially with a small-incision technique.
Details
- Title: Subtitle
- Visual Acuity, Refractive Error, and Endothelial Cell Density 6 and 12 Months After Deep Lamellar Endothelial Keratoplasty
- Creators
- Parley D. Fillmore - Univ Iowa, Dept Ophthalmol & Visual Sci, Iowa City, IA 52242 USAJohn E. Sutphin - University of KansasKenneth M. Goins - Univ Iowa, Dept Ophthalmol & Visual Sci, Iowa City, IA 52242 USA
- Resource Type
- Journal article
- Publication Details
- Cornea, Vol.29(6), pp.601-606
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/ICO.0b013e3181c11de4
- PMID
- 20458237
- ISSN
- 0277-3740
- eISSN
- 1536-4798
- Number of pages
- 6
- Language
- English
- Date published
- 06/01/2010
- Academic Unit
- Ophthalmology and Visual Sciences
- Record Identifier
- 9984806611602771
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