PKP versus LKP: rehabilitation speed, optical performance, endothelial cell loss
In: Acta Ophthalmologica Scandinavica, Jg. 85 (2007-10-02)
Online
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Zugriff:
This presentation will provide a critical comparison between penetrating and lamellar keratoplasty as far as rehabilitation speed, optical performance, endothelial cell loss and immunological rejection rate is concerned. Deep anterior lamellar keratoplasty has the advantage of retaining a stronger globe and no risk of late endothelial failure, implying patients might be able to keep their graft for the rest of their life. There is also a reduced risk of graft rejection, or at least the damage caused will not be directed towards the vital endothelial cells. This however seems to go at the expense of visual acuity and quality. High postoperative astigmatism remains an issue and interface haze -when dissection is not down to bare Descemets- limits the vision to 20/40 in some cases. The decrease in recipient endothelial cell loss mimics the physiological cell loss of non operated corneas except maybe in patients with macular dystrophy. The results of deep endothelial keratoplasty (either DLEK of DSAEK) seem very promising as far as astigmatic control is concerned as there is virtually no astigmatic change induced. Vision outcome in the largest reported series of DLEK was a vision of 20/40 or better in 49% of eyes. This compared to a percentage of respectively 62% and 87% in patients with DSEK or DSAEK. Contrary to common belief endothelial rejection can still hapen in patients undergoing deep endothelial keratoplasty. DS(A)EK seems to induce more endothelial cell loss than DLEK which is probably a direct consequence of the current taco folding techniques. New insertion devices are currently developped to minimise this increased cell loss.
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PKP versus LKP: rehabilitation speed, optical performance, endothelial cell loss
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Autor/in / Beteiligte Person: | Kestelyn, P ; Claerhout, I |
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Zeitschrift: | Acta Ophthalmologica Scandinavica, Jg. 85 (2007-10-02) |
Veröffentlichung: | Wiley, 2007 |
Medientyp: | unknown |
ISSN: | 1395-3907 (print) |
DOI: | 10.1111/j.1600-0420.2007.01063_3043.x |
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