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Cornea:
doi: 10.1097/ICO.0b013e31823f8c59
Clinical Science

Endothelial Keratoplasty Without Descemet Stripping After Failed Penetrating Keratoplasty

Heitor de Paula, Fernando MD*,†; Kamyar, Roheena MD*; Shtein, Roni M. MD, MS*; Sugar, Alan MD*; Mian, Shahzad I. MD*

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Abstract

Purpose: To evaluate outcomes of endothelial keratoplasty (EK) without Descemet membrane stripping for treatment of failed penetrating keratoplasty (PKP).

Methods: Retrospective cohort study of all eyes that underwent EK without Descemet membrane stripping for failed PKP at one institution between May 2008 and June 2010, with follow-up to 12 months. Main outcome measures were best-corrected visual acuity (BCVA), dislocation rate, and graft failure.

Results: Twenty-two eyes of 22 patients underwent non-Descemet stripping EK with a mean follow-up of 8.8 months (±3.41; range, 3–12 months). The mean preoperative BCVA was logarithm of the minimum angle of resolution (logMAR) 1.43 (±0.72; range, 0.3–3; Snellen, 20/537; N = 22). The mean postoperative BCVA was logMAR 0.97 (±0.88; range, 0–3; N = 21) at 1 month, 0.76 logMAR (±0.74; range, 0.1–3; N = 21) at 3 months, 0.75 (±0.77; range, 0–3; N = 17) at 6 months, and logMAR 0.55 (±0.38; range, 0.18–1; Snellen, 20/70; N = 9) at 1 year. Eight eyes (36.6%) had graft dislocations requiring one rebubbling procedure in 6 of 8 eyes and 2 rebubblings in the other 2 eyes. All grafts were successfully reattached. Graft failure occurred in 2 of 22 eyes (9%), with 1 eye (5%) undergoing repeat EK and 1 eye (5%) undergoing PKP.

Conclusions: EK without Descemet membrane stripping is an effective option for management of eyes with failed PKP and may be a preferable alternative to a repeat PKP.

© 2012 Lippincott Williams & Wilkins, Inc.

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