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Outcomes of repeat Descemet's stripping automated endothelial keratoplasty

Poster Details

First Author: C.Bovone ITALY

Co Author(s):    L. Mattioli   R. Spena   M. Busin              

Abstract Details

Purpose:

To compare the results of repeat Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) with those of primary DSAEK.

Setting:

Retrospective cohort study of eyes operated at a private hospital by a single surgeon (MB). Villa Igea Private Hospital Forli, Italy

Methods:

The records of all eyes undergoing DSAEK at Villa Igea private Hospitals (Forlì, Italy) between January 2005 and June 2014 were reviewed. All eyes receiving a repeat DSAEK were assigned to the study group (SG) while all eyes receiving only primary DSAEK during the same period were assigned to the control group (CG) Main outcome measures were best spectacle-corrected visual acuity (BSCVA), graft detachment rate, postoperative endothelial cell loss, immunologic rejection and graft survival rates. Differences between groups were statistically evaluated using a two tailed Student’s t-test or Fisher’s exact test as appropriate.

Results:

SG included 108 and CG 1033 eyes.The indications for repeat DSAEK were endothelial cell loss (56.5%),endothelial rejection (18.5%),primary failure (17.6%),host-graft interface abnormalities(4.6%) and infection( 2.8%).Postoperative BSCVA didn't differ between the repeat DSAEK and control eyes (p=0.0506).Endothelial cell loss was higher in SG both during first 6 months(p=0.003) and between 6 months and 3 years(p=0.03).Rates of graft detachment(p=0.32) and rejection episodes (p=0.3) were similar.The survival rate of repeat DSAEK grafts (90.7%) didn't differ significantly (p=0.895) from primary DSAEK (92.5%).75 eyes underwent both primary and repeat DSAEK.A paired comparison showed that the average of BSCVA recorded during follow-up didn't differ between primary and repeat DSAEK (p=0.39).Mean spherical equivalent didn't differ between the groups (p=0.07), nor did the rates of graft detachment (p=0.37).

Conclusions:

Repeat DSAEK can provide visual acuity and graft survival rates that are comparable to those of primary DSAEK.

Financial Disclosure:

One or more of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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