To evaluate whether the visual, topographic, and endothelial cell count result s observed 1 year after deep lamellar endothelial keratoplasty (DLEK) surgery re main stable up to 2 years after surgery. Prospective, non...To evaluate whether the visual, topographic, and endothelial cell count result s observed 1 year after deep lamellar endothelial keratoplasty (DLEK) surgery re main stable up to 2 years after surgery. Prospective, noncomparative, interventi onal case series. Twenty eyes of 20 patients with corneal edema from Fuchs’endo thelial dystrophy. Deep lamellar endothelial keratoplasty endothelial replacemen t surgery, with a 9.0-mm or 9.5-mm scleral access incision and a specialized i ntrastromal trephine, was performed. Snellen visual acuities, corneal topography , and endothelial cell counts were prospectively measured preoperatively and 1 y ear and 2 years after DLEK. Uncorrected and best spectacle-corrected visual acu ity (BSCVA), refractive and topographic astigmatism, mean corneal curvature, top ographic regularity and symmetry, and endothelial cell density. At 1 year postop eratively, BSCVA averaged 20/50 (range, 20/25-20/200), spherical equivalents (S E)averaged -0.194±1.521 diopters (D), manifest refraction (MR) astigmatism ave raged 2.04±1.05 D (range, 0.0-4.0 D), topographic astigmatism averaged 2.3±1. 1 D, mean corneal curvature was 43.2±1.8 D, the surface regularity index (SRI) averaged 1.16±0.41, and the surface asymmetry index (SAI) averaged 1.05±1.09. At 2 years postoperatively, BSCVA averaged 20/48 (range, 20/25-20/200), SEavera ged-0.369±1.267 D, MR astigmatism averaged 1.76±0.66 D (range, 0.75-3.0 D), topographic astigmatism averaged 2.4±1.1 D, mean corneal curvature was 43.6±1. 8 D, the SRI averaged 1.13±0.44, and the SAI averaged 0.76±0.59. There was no significant change in visual or topographic parameters between 1 year and 2 year s postoperatively (P > 0.05). Endothelial cell counts averaged 2 335±468 cells/ mm2 at 1 year and 2 151±457 cells/mm2 at 2 years postoperatively (P=0.041). Dee p lamellar endothelial keratoplasty provides stable refractions, corneal topogra phy, and endothelial cell densities as long as 2 years after surgery. The absenc e of corneal sutures in this technique seems to prevent the sutures in/sutures o ut changes in SE refractions and corneal topography sometimes seen after penetra ting keratoplasty (PK). Deep lamellar endothelial keratoplasty is, therefore, an excellent alternative to PK for patients with endothelial dystrophies.展开更多
文摘To evaluate whether the visual, topographic, and endothelial cell count result s observed 1 year after deep lamellar endothelial keratoplasty (DLEK) surgery re main stable up to 2 years after surgery. Prospective, noncomparative, interventi onal case series. Twenty eyes of 20 patients with corneal edema from Fuchs’endo thelial dystrophy. Deep lamellar endothelial keratoplasty endothelial replacemen t surgery, with a 9.0-mm or 9.5-mm scleral access incision and a specialized i ntrastromal trephine, was performed. Snellen visual acuities, corneal topography , and endothelial cell counts were prospectively measured preoperatively and 1 y ear and 2 years after DLEK. Uncorrected and best spectacle-corrected visual acu ity (BSCVA), refractive and topographic astigmatism, mean corneal curvature, top ographic regularity and symmetry, and endothelial cell density. At 1 year postop eratively, BSCVA averaged 20/50 (range, 20/25-20/200), spherical equivalents (S E)averaged -0.194±1.521 diopters (D), manifest refraction (MR) astigmatism ave raged 2.04±1.05 D (range, 0.0-4.0 D), topographic astigmatism averaged 2.3±1. 1 D, mean corneal curvature was 43.2±1.8 D, the surface regularity index (SRI) averaged 1.16±0.41, and the surface asymmetry index (SAI) averaged 1.05±1.09. At 2 years postoperatively, BSCVA averaged 20/48 (range, 20/25-20/200), SEavera ged-0.369±1.267 D, MR astigmatism averaged 1.76±0.66 D (range, 0.75-3.0 D), topographic astigmatism averaged 2.4±1.1 D, mean corneal curvature was 43.6±1. 8 D, the SRI averaged 1.13±0.44, and the SAI averaged 0.76±0.59. There was no significant change in visual or topographic parameters between 1 year and 2 year s postoperatively (P > 0.05). Endothelial cell counts averaged 2 335±468 cells/ mm2 at 1 year and 2 151±457 cells/mm2 at 2 years postoperatively (P=0.041). Dee p lamellar endothelial keratoplasty provides stable refractions, corneal topogra phy, and endothelial cell densities as long as 2 years after surgery. The absenc e of corneal sutures in this technique seems to prevent the sutures in/sutures o ut changes in SE refractions and corneal topography sometimes seen after penetra ting keratoplasty (PK). Deep lamellar endothelial keratoplasty is, therefore, an excellent alternative to PK for patients with endothelial dystrophies.
