The Descemet Stripping Automated Endothelial Keratoplasty (DSAEK), Venting versus Non-venting incision - A review of 21 cases.
Descemet Stripping Automated Endothelial Keratoplasty (DSAEK), Venting versus Non-venting incision - A review of 21 cases.
Keywords:
DSAEK(Descemet stripping automated endothelial keratoplasty), DSEK( descemet stripping endothelial keratoplasty), CME(cystoid macular edema), PKP(penetrating keratoplasty), PGF(primary graft failure)Abstract
Purpose: The purpose of this study to analyze the advantage/disadvantage of venting versus non-venting incision in descemet stripping automated endothelial keratoplasty (DSAEK).
Material and Methods: This study was performed in the department of ophthalmology Khyber Teaching Hospital Peshawar, Pakistan from 1st Jan 2017 to April 2019. The charts of all patients were reviewed retrospectively. DSAEK was performed by a single surgeon, using the similar technique.
Any complication either intra operative or post operative, which happened, were recorded and managed either medically, or by appropriate surgical means. At the end of the study the data was compiled and analyzed.
Results: Total 21 patients, 5 (23.80%) males and 16 (76.20%) females were included in the study. Their mean age was 52.62±7.64 years. All patients had pseudophakic corneal edema/bullous keratopathy. 20 (95.23%) out the total had posterior chamber intraocular lens and only 1 (4.7%) had anterior chamber intraocular lens. All patients had visual acuity less than 5/60 (0.08). Mean value before DSAEK procedure was 0.0381 ± 0.01721. Best corrected visual acuity (BCVA) after DSAEK in venting cases was 6/24 (0.25) in one case (4.76%), 6/36 (0.16) in one case (4.76%), 6/60 (0.1) in four cases (19.04%) and 3/60 (0.05) in four cases (19.04%). Mean values after DSAEK in venting cases was 0.2810±0.19393, P-value 0.004. BCVA after DSAEK in non-venting was 6/12 (0.5) in one case (4.76%), 6/18 (0.32) in one case (4.76%), 6/24 (0.25) in four cases (19.04%), 6/36 (0.16) in one case (4.76%) and 6/60 (0.1) in four cases (19.04%). Mean value after DSAEK in non-venting cases were 0.2164±0.12372, P-values 0.001. P-values after DSAEK in venting versus non-venting cases were 0.001. Donor dislocation 4.76%, air induced pupillary glaucoma 9.52% and partial donor non-attachment 4.76% in venting cases. Air induced pupillary glaucoma 4.76% and partial donor non-attachment in 4.76% are the only early post operative complication in non-venting cases.
Conclusion: DSAEK is a promising procedure for decompensated cornea which has damaged endothelium. The complications are more in venting than the non venting cases and similarly best corrected visual acuity remain good in non-venting cases.
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