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[Post operation complications analysis and their treatment of Descemet's stripping automated endothelium keratoplasty].

AbstractOBJECTIVE:
To summarize intra and post operation complications and their treatment of Descemet's Stripping Automated Endothelium Keratoplasty (DSAEK), and provide our experience for its development in China.
METHODS:
Retrospective case study. Forty-seven eyes of 42 patients underwent DSAEK performed by one surgeon. Indications include: Pseudophakic or aphakic Bullous Keratopathy, 27 eyes (57.4%); Fuchs Endothelial Dystrophy, 7 eyes (14.9%); endothelial decompensation post vitrectomy, 3 eyes (6.4%); iridocorneal endothelial syndrome (ICE), 3 eyes (6.4%); congenital glaucoma, 3 eyes (6.4%); graft failure post endothelial keratoplasty, 3 eyes (6.4%); endothelial decompensation after open ocular injury and intraocular foreign body, 1 eye (2.1%). Nineteen eyes underwent single DSAEK (40.4%); eight combined phacoemulsification and intraocular lens implantation (17.0%); eight combined anterior chamber IOL (AC-IOL) removal plus anterior segment vitrectomy and posterior chamber IOL (PC-IOL) implantation (17.0%); eight combined anterior segment vitrectomy and PC-IOL suspension (17.0%); two combined cataract extraction and anterior segment vitrectomy (4.3%); two failed in DSAEK and underwent penetrating keratoplasty (4.3%).
RESULTS:
Dislocation is the most common postoperative complications. Ten eyes underwent dislocation in 47 eyes (21.3%), which was solved by air and viscoelastic agent injection. High intraocular pressure happened in 12 eyes (25.5%), in 11 of which had a history of glaucoma and 1 with ICE. After drug treatment, ten patients had stable intraocular pressure and two patients underwent ciliary body photocoagulation surgery (1 case with anterior chamber intraocular lens, 1 case with ICE). Reactions happened in 2 cases (4.3%) patients, including 1 case with anterior chamber IOL (AC-IOL) rehabilitating after drug treatment and the other with Fuch's corneal endothelial dysfunction being regrafted.
CONCLUSION:
Dislocation is the most common complication after corneal endothelial keratoplasty, and air injection in anterior chamber is a common and effective method; High intraocular pressure is the second postoperative complication. Preoperative history of glaucoma is closely related to postoperative high intraocular pressure.
AuthorsJing Hong, Rongmei Peng, Yansheng Hao, Hongqiang Qu
Journal[Zhonghua yan ke za zhi] Chinese journal of ophthalmology (Zhonghua Yan Ke Za Zhi) Vol. 50 Issue 4 Pg. 254-60 (Apr 2014) ISSN: 0412-4081 [Print] China
PMID24931150 (Publication Type: English Abstract, Journal Article)
Topics
  • Cataract Extraction
  • China
  • Corneal Diseases (surgery)
  • Descemet Stripping Endothelial Keratoplasty (adverse effects)
  • Endothelium
  • Fuchs' Endothelial Dystrophy (surgery)
  • Glaucoma (complications)
  • Humans
  • Keratoplasty, Penetrating
  • Lens Implantation, Intraocular
  • Ocular Hypertension (etiology)
  • Phacoemulsification
  • Postoperative Complications (diagnosis, therapy)
  • Retrospective Studies
  • Visual Acuity

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