Graft Detachment Rate in DSEK/DSAEK After Same-Day Complete Air Removal.
| Autor: | Lehman RE; Departments of Ophthalmology, *Baylor Scott and White Hospital, Temple, TX; and †Central Texas Veterans Administration, Temple, TX., Copeland LA, Stock EM, Fulcher SF |
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| Jazyk: | angličtina |
| Zdroj: | Cornea [Cornea] 2015 Nov; Vol. 34 (11), pp. 1358-61. |
| DOI: | 10.1097/ICO.0000000000000617 |
| Abstrakt: | Purpose: We retrospectively analyzed the rate of graft detachment from 310 Descemet stripping endothelial keratoplasty (DSEK)/Descemet stripping automated endothelial keratoplasty (DSAEK) cases performed by a single surgeon over a 10-year period using same-day complete air removal. Secondary outcome measures including primary graft failure, late endothelial graft failure, rejection events, and steroid-induced ocular hypertension were also analyzed. Methods: A retrospective chart review was performed on all patients receiving DSEK/DSAEK for any cause by the same surgeon at 2 separate institutions from January 2005 to December 2014. The air bubble used to promote graft-host apposition was completely removed after 1 hour. Descriptive statistical analysis was used to report the rates of graft detachment, and χ analysis was used to assess for associations with secondary outcomes. Results: Among 310 endothelial keratoplasties analyzed, there were 19 graft detachments (6.1%). The graft detachment rate was higher during the learning curve, but rapidly declined with experience, and was 1.3% for the last 79 cases over a 4-year period. No primary graft failures were reported. The rate of steroid-induced ocular hypertension was 20%. The rate of graft failure was 8%. The rate of graft rejection events was 10.7%. Two of the 6 patients (33%) who underwent trabeculectomy before endothelial keratoplasty suffered a detachment. Conclusions: A graft detachment rate as low as 1.3% can be achieved in DSEK/DSAEK with same-day complete air removal shortly after surgery. Factors believed to contribute to a low detachment rate include complete interface fluid removal and reconstitution of the normal anterior chamber milieu to assist corneal endothelial function. |
| Databáze: | MEDLINE |
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