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Outcomes of endothelial keratoplasty in pseudophakic corneal oedema: with or without Descemet's membrane stripping
  1. Ashik Mohamed1,
  2. Anil Raj KS2,
  3. Sunita Chaurasia2,
  4. Muralidhar Ramappa2
  1. 1Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
  2. 2Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, India
  1. Correspondence to Dr Muralidhar Ramappa, Cornea and Anterior Segment services, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad 500034, Telangana, India; muralidhar{at}lvpei.org

Abstract

Aims To evaluate and compare outcomes of Descemet's stripping endothelial keratoplasty (DSEK) with non-DSEK (nDSEK) in pseudophakic corneal oedema (PCE).

Methods The study was a prospective, non-consecutive, comparative, interventional case series. Twenty-six patients with PCE were randomised into two groups. Group 1 comprised of those cases that had undergone conventional DSEK, and group 2 consisted of those that had nDSEK for PCE between 2010 and 2012. The data on demographics and clinical characteristics were collected from all patients. Any intraoperative and early and late postoperative complications were also noted. The primary outcome measure was postoperative functional success. Graft survival and complications were analysed as secondary outcomes.

Results The median best-corrected visual acuities at 6 months postoperatively in groups 1 and 2 were 0.18 (IQR 0.10–0.30) and 0.44 (IQR 0.18–0.51), respectively (p=0.11). Corneal oedema cleared in all patients. During the early postoperative period, a patient in group 2 had lenticule detachment managed by rebubbling.

Conclusions nDSEK has outcomes similar to DSEK in PCE with advantages of decreased surgical time and avoidance of inadvertent pull on the posterior stromal fibres that may occur during Descemet's stripping.

  • Cornea
  • Treatment Surgery

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