Clinical Outcomes of Penetrating Keratoplasty and Descemet Stripping Automated Endothelial Keratoplasty in Asian Population with American Corneas

Autor: Hsin-Yuan Tan, Po-Yuan Chen, Hsin-Chiung Lin, Lung-Kun Yeh, Wei-Chi Wu, Yaa-Jyuhn James Meir, Fang-Chi Hsiao, David Hui-Kang Ma, Ching-Hsi Hsiao, Hung-Chi Chen
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
PK
Descemet membrane
Health
Toxicology and Mutagenesis

Corneal graft
Visual Acuity
lcsh:Medicine
Article
Corneal Diseases
Cornea
03 medical and health sciences
0302 clinical medicine
Asian People
Ophthalmology
medicine
Humans
DSAEK
Survival rate
030304 developmental biology
Aged
Retrospective Studies
long term clinical outcomes
0303 health sciences
business.industry
lcsh:R
Significant difference
Graft Survival
Public Health
Environmental and Occupational Health

Middle Aged
Descemet stripping automated endothelial keratoplasty
Tissue Donors
United States
imported corneas
Transplantation
Treatment Outcome
030221 ophthalmology & optometry
Asian population
Female
sense organs
Complication
business
Descemet Stripping Endothelial Keratoplasty
Keratoplasty
Penetrating
Zdroj: International Journal of Environmental Research and Public Health
Volume 16
Issue 22
International Journal of Environmental Research and Public Health, Vol 16, Iss 22, p 4547 (2019)
ISSN: 1660-4601
DOI: 10.3390/ijerph16224547
Popis: To determine the comparative efficacy and safety of penetrating keratoplasty (PK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the Asian population receiving imported donor corneas, our single-center retrospective study provides analysis supporting the transition from PK to DSAEK in the Asian population using imported American donor corneas. We analyzed 259 patients with 241 and 57 cases of PK and DSAEK respectively during 2008 to 2017 using imported corneas at Chang Gung Memorial Hospital, Linkou, Taiwan. In terms of long-term graft survival analysis, there was no difference between PK and DSAEK (log-rank p = 0.386, HR = 0.920, 95% CI: [0.641&ndash
1.380]). However, Cox proportional regression analysis revealed that corneal survival rate of DSAEK group in the first 100 days after transplantation was inferior than that of PK group (log-rank p <
0.001, HR = 2.733, 95% CI: [1.501&ndash
4.977])]. Despite the inferior survival rate, there were significantly less neovascularization and Descemet membrane folds in the DSAEK group. Importantly, the non-complication rate of DSAEK was much higher than that of PK with significant difference (PK, 25.7% vs DSAEK 42.0%, p = 0.022). Collectively, DSAEK is suggested as an alternative surgical modality in Asian patients using imported American donor corneas because of less complication, and no difference in long-term corneal graft survival rates between PK and DSAEK.
Databáze: OpenAIRE