Comparison of Long-Term Outcomes of Visual Function and Endothelial Cell Survival After Descemet Stripping Automated Endothelial Keratoplasty and Penetrating Keratoplasty Using Mixed-Effects Models

Sosuke Ishiyama, Yosai Mori, Ryohei Nejima, Toshihiko Tokudome, Shigeto Shimmura, Kazunori Miyata, Shiro Amano

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

PURPOSE:: To compare the long-term outcomes of visual function and endothelial cell survival after Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK). METHODS:: The cohort included 108 eyes from 97 patients who underwent primary PK and 85 eyes from 78 patients who underwent primary DSAEK at Miyata Eye Hospital in Japan. Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), endothelial cell density, and four components from Fourier harmonic analysis of topography data (spherical component, regular astigmatism component, asymmetry component, and higher-order irregularity component) were retrospectively compared between PK and DSAEK at each time point for 5 years using mixed-effects models. Subgroup analyses were performed to compare the effect of PK and DSAEK on visual acuity. RESULTS:: Average BSCVA was significantly better in the DSAEK group compared with that in the PK group both preoperatively and postoperatively. Subgroup analyses revealed that average changes in BSCVA from preoperative baseline in eyes with preoperative logarithm of the minimum angle of resolution BSCVA between 0.39 and 1.0 and between 1.3 and 2.0 were not significantly different between the PK and DSAEK groups at all postoperative time points. All components from Fourier harmonic analysis were significantly higher after PK than DSAEK at almost all postoperative time points. There were no significant differences in endothelial cell density between PK and DSAEK after 3 years. CONCLUSIONS:: PK and DSAEK provide similar recovery of BSCVA and endothelial cell survival at 5 years after surgery.

Original languageEnglish
JournalCornea
DOIs
Publication statusAccepted/In press - 2016 Aug 24

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Descemet Stripping Endothelial Keratoplasty
Penetrating Keratoplasty
Cell Survival
Endothelial Cells
Visual Acuity
Fourier Analysis
Cell Count
Astigmatism
Japan

ASJC Scopus subject areas

  • Medicine(all)
  • Ophthalmology

Cite this

Comparison of Long-Term Outcomes of Visual Function and Endothelial Cell Survival After Descemet Stripping Automated Endothelial Keratoplasty and Penetrating Keratoplasty Using Mixed-Effects Models. / Ishiyama, Sosuke; Mori, Yosai; Nejima, Ryohei; Tokudome, Toshihiko; Shimmura, Shigeto; Miyata, Kazunori; Amano, Shiro.

In: Cornea, 24.08.2016.

Research output: Contribution to journalArticle

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AU - Nejima, Ryohei

AU - Tokudome, Toshihiko

AU - Shimmura, Shigeto

AU - Miyata, Kazunori

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N2 - PURPOSE:: To compare the long-term outcomes of visual function and endothelial cell survival after Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK). METHODS:: The cohort included 108 eyes from 97 patients who underwent primary PK and 85 eyes from 78 patients who underwent primary DSAEK at Miyata Eye Hospital in Japan. Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), endothelial cell density, and four components from Fourier harmonic analysis of topography data (spherical component, regular astigmatism component, asymmetry component, and higher-order irregularity component) were retrospectively compared between PK and DSAEK at each time point for 5 years using mixed-effects models. Subgroup analyses were performed to compare the effect of PK and DSAEK on visual acuity. RESULTS:: Average BSCVA was significantly better in the DSAEK group compared with that in the PK group both preoperatively and postoperatively. Subgroup analyses revealed that average changes in BSCVA from preoperative baseline in eyes with preoperative logarithm of the minimum angle of resolution BSCVA between 0.39 and 1.0 and between 1.3 and 2.0 were not significantly different between the PK and DSAEK groups at all postoperative time points. All components from Fourier harmonic analysis were significantly higher after PK than DSAEK at almost all postoperative time points. There were no significant differences in endothelial cell density between PK and DSAEK after 3 years. CONCLUSIONS:: PK and DSAEK provide similar recovery of BSCVA and endothelial cell survival at 5 years after surgery.

AB - PURPOSE:: To compare the long-term outcomes of visual function and endothelial cell survival after Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK). METHODS:: The cohort included 108 eyes from 97 patients who underwent primary PK and 85 eyes from 78 patients who underwent primary DSAEK at Miyata Eye Hospital in Japan. Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), endothelial cell density, and four components from Fourier harmonic analysis of topography data (spherical component, regular astigmatism component, asymmetry component, and higher-order irregularity component) were retrospectively compared between PK and DSAEK at each time point for 5 years using mixed-effects models. Subgroup analyses were performed to compare the effect of PK and DSAEK on visual acuity. RESULTS:: Average BSCVA was significantly better in the DSAEK group compared with that in the PK group both preoperatively and postoperatively. Subgroup analyses revealed that average changes in BSCVA from preoperative baseline in eyes with preoperative logarithm of the minimum angle of resolution BSCVA between 0.39 and 1.0 and between 1.3 and 2.0 were not significantly different between the PK and DSAEK groups at all postoperative time points. All components from Fourier harmonic analysis were significantly higher after PK than DSAEK at almost all postoperative time points. There were no significant differences in endothelial cell density between PK and DSAEK after 3 years. CONCLUSIONS:: PK and DSAEK provide similar recovery of BSCVA and endothelial cell survival at 5 years after surgery.

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