Study of factors for unsuitability of DSAEK in cases of corneal decompensation following cataract surgery

Namrata Sharma1, Ritika Sachdev1, Ravindra M. Pandey2, Jeewan S. Titiyal1, Rajesh Sinha1, Radhika Tandon1, Rasik B. Vajpayee3,1
1R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
2Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
3Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia

Tóm tắt

To evaluate suitability of Descemet’s stripping automated endothelial keratoplasty (DSAEK) in cases of corneal decompensation following cataract surgery. In this cross-sectional case series, 90 eyes of 90 patients were evaluated at a tertiary eye care centre. Cases with central corneal scarring or vascularisation, complicated aphakia with significant iris tissue defects and extensive synechaie or posterior segment pathology precluding visual recovery were classified as unsuitable for DSAEK. Of 90 eyes, 42 (46.67%) were unsuitable for DSAEK. Multivariate logistic regression analysis, revealed that patients presenting more than a year after cataract surgery had 7.5-fold odds of being unsuitable for DSAEK as compared with those who presented earlier(OR 7.5; CI 2.0–29.1). Patients with BCVA poorer than 0.06 at initial presentation had 5.0 times odds of being unsuitable for DSAEK (OR 5.0; CI 1.0–24.2). Patients who had prior non-phacoemulsification cataract surgery were 5.5 times less likely to be candidates for DSAEK as compared to those who had prior phacoemulsification (OR 5.5; CI 1.5–19.9) and those with anterior chamber IOL or aphakia were 5.0 times less likely suitable for DSAEK, in contrast to posterior chamber intraocular lenses (OR 5.0; CI 1.3–18.7). The type of cataract surgery, time to presentation and initial visual acuity play a role in determining the suitability of performing DSAEK in patients with corneal decompensation after cataract surgery.

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Tài liệu tham khảo

Price MO, Price FW (2007) Descemet’s stripping endothelial keratoplasty. Curr Opin Ophthalmol 189(4):290–294

Terry MA, Shamie N, Chen ES, Philips PM, Shah AK, Hoar KL, Friend DJ (2009) Endothelial Keratoplasty for Fuch’s dystrophy with cataract: complications and clinical results of the new triple procedure. Ophthalmology 116(4):631–639

O’Brien PD, Lake DB, Saw VP, Rostron CK, Dart JK, Allan BD (2008) Endothelial keratoplasty: case selection and learning curve. Cornea 27(10):1114–1118

Rose l, Briceno CA, Stark WJ, Gloria DG, Jun AS (2007) Descemet stripping and automated endothelial keratoplasty (DSAEK) in eyes with failed penetrating keratoplasty. Cornea 26(6):692–696

Ponchel C, Malecaze F, Arne JL, Fournie P (2009) Descemet stripping automated endothelial keratoplasty in a child with Descemet membrane breaks after forceps delivery. Cornea 28(3):298–303

Bahar I, Kaiserman I, Buys Y, Rootman D (2008) Descemet’s stripping with endothelial keratoplasty in iridocorneal endothelial syndrome. Ophthalmic Surg Lasers Imaging 39(1):54–56

Sony P, Sharma N, Sen S, Vajpayee RB (2005) Indications of keratoplasty in northern India. Cornea 24(8):989–991

Ham L, Balachandran C, Verschoor CA, van der Wees J, Melles GR (2009) Visual rehabilitation rate after isolated descemet membrane transplantation: descemet membrane endothelial keratoplasty. Arch Ophthalmol 127(3):252–255

Dapena I, Ham L, Melles GR (2009) Endothelial keratoplasty: DSEK/DSAEK or DMEK—The thinner the better? Curr Opin Ophthalmol 20(4):299–307

Bahar I, Kaiserman I, Levinger E, Sansanayudh W, Slomovic AR, Rootman DS (2009) Retrospective contralateral study comparing descemet stripping automated endothelial keratoplasty with penetrating keratoplasty. Cornea 28(5):485–488

Jun B, Kuo AN, Afshari NA, Carlson AN, Kim T (2009) Refractive change after descemet stripping automated endothelial keratoplasty surgery and its correlation with graft thickness and diameter. Cornea 28(1):19–23

Bahar I, Kaiserman I, McAllum P, Slomovic A, Rootman D (2008) Comparison of posterior lamellar keratoplasty techniques to penetrating keratoplasty. Ophthalmology 115(9):1525–1533

Price FW Jr, Price MO (2006) Descemet’s stripping and endothelial keratoplasty in 200 eyes; early challenges and techniques to enhance donor adherence. J Cataract Refract Surg 32(3):411–418

Chen ES, Terry MA, Shamie N, Hoar KL, Friend DJ (2008) Descemet stripping automated endothelial keratoplasty: six month results in a prospective study of 100 eyes. Cornea 27(5):514–520

Suh LH, Yoo SH, Deobhakta A, Donaldson KE, Alfonso EC, Culbertson WW, O’ Brien TP (2008) Complications of descemet’s stripping with automated endothelial keratoplasty: survey of 118 eyes at one institute. Ophthalmology 115(9):1517–1524

Grueterich M, Messmer E, Kampik A (2009) Posterior lamellar dislocation into the vitreous cavity during descemet stripping automated endothelial keratoplasty. Cornea 28:93–96

Suh LH, Kymionis GD, Culbertson WW, O’Brien TP, Yoo SH (2008) Descemet’s stripping with endothelial keratoplasty in aphakic eyes. Arch Ophthalmol 126(2):268–270

Vajpayee RB, Sharma N, Jhanji V, Titiyal JS, Tandon R (2007) One donor cornea for 3 recipients: a new concept for corneal transplantation surgery. Arch Ophthalmol 125(4):552–554