Abstract:
PURPOSE:To report 5-year outcomes for graft survival and endothelial cell survival after Descemet stripping endothelial keratoplasty (DSEK) including regression modeling for cell survival over time. METHODS:This is a single-institution, retrospective, consecutive interventional series of 210 primary DSEK grafts operated for low-to-moderate risk indications, specifically Fuchs dystrophy and bullous keratopathy. Primary outcomes were cumulative graft survival and % endothelial cell loss from 3 months through 5 years; the secondary outcome was to trend endothelial cell density over time by least-squares and mixed nonlinear modeling. RESULTS:Cumulative graft survival was high at 99%, 98%, and 94% at 1, 3, and 5 years, respectively. Mean endothelial cell loss was (mean ± SD) 44% ± 16%, 56% ± 17%, and 67% ± 13% at 1, 3, and 5 years. The trend in mean endothelial cell density over time by least square regression was accurately and parsimoniously described by a straight line taking earliest values (3 mo) through to 5 years, with a rate of cell loss of 148 ± 13 cells·mm·yr. Higher-order polynomial and exponential models did not provide a closer regression fit. Mixed nonlinear modeling using exponential decay equations confirmed a relatively stable rate of cell loss for DSEK from 3 months through to 5 years, in contrast to penetrating keratoplasty models using similar techniques in previous studies. CONCLUSIONS:DSEK graft survival is high in our series through 5 years. Endothelial cell loss occurs at a relatively constant albeit low-grade rate from the earliest postoperative measurements through 5 years.
journal_name
Corneajournal_title
Corneaauthors
Fajgenbaum MA,Hollick EJdoi
10.1097/ICO.0000000000001177subject
Has Abstractpub_date
2017-05-01 00:00:00pages
553-560issue
5eissn
0277-3740issn
1536-4798journal_volume
36pub_type
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