Original articleGraft Rejection After Descemet's Stripping Automated Endothelial Keratoplasty: Graft Survival and Endothelial Cell Loss
Section snippets
Methods
All patients were enrolled as part of an ongoing, institutional review board–approved clinical protocol for a long-term prospective study of EK in patients with endothelial dysfunction. We performed 753 DSAEK procedures in eyes with Fuchs' endothelial dystrophy between September 2005 and November 2010. Among those, 639 cases (85%) were followed at our clinic for ≥6 months; 2 others did not have follow-up, but were noted to have evidence of clinical rejection during an early office visit or
Results
Table 1 highlights some demographics of patients who developed graft rejection episodes and those who did not. The groups were similar with respect to age, gender, ECD of the donor tissue, best-spectacle corrected visual acuity, and ultrasonic pachymetry. The group of patients experiencing subsequent graft rejection had a small but significant rise in preoperative intraocular pressure (P<0.001). The mean follow-up time was approximately 32 months for patients with graft rejection episodes and
Discussion
Graft rejection is a relatively common postoperative complication of DSAEK surgery that ranges from 0% to 45% in the published literature with an average rejection rate of 10%.6 Our series of patients with at least 6 month follow-up had a total graft rejection rate of 7.3% among all eyes.
Jordan et al11 recently published a large series of 598 eyes with primary Descemet's stripping with EK, evaluating the incidence, symptoms and characteristics of Descemet's stripping with EK rejection. They
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Cited by (0)
Manuscript no. 2011-20.
Financial Disclosure(s): The authors have made the following disclosures:
Mark A. Terry – Royalty payments – Bausch and Lomb Surgical for the DSAEK surgical instruments which he designed.