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Corneal Transplant Method Appears Safe and Effective

Descemet's stripping endothelial keratoplasty used to treat endothelial diseases of the cornea

TUESDAY, Sept. 8 (HealthDay News) -- A form of corneal transplantation to treat eye conditions characterized by corneal endothelial dysfunction is safe and effective, according to a review in the September issue of Ophthalmology.

W. Barry Lee, M.D., from Eye Consultants of Atlanta, and colleagues reviewed the medical literature and identified 34 articles examining safety and outcomes of Descemet's stripping endothelial keratoplasty (DSEK) for the surgical treatment of endothelial diseases of the cornea.

The researchers found that the most common complications reported were posterior graft dislocations (mean, 14 percent), endothelial graft rejection (10 percent), primary graft failure (5 percent), and iatrogenic glaucoma (3 percent). The average endothelial cell loss was 37 percent at six months and 42 percent at 12 months. After a mean of nine months, the average best-corrected Snellen visual acuity ranged from 20/34 to 20/66. Clear grafts were present at one year in 55 to 100 percent of cases.

"The evidence reviewed is supportive of DSEK being a safe and effective treatment for endothelial diseases of the cornea," Lee and colleagues conclude. "Descemet's stripping (automated) endothelial keratoplasty seems to be similar to penetrating keratoplasty in terms of surgical risks and complication rates, graft survival (clarity) and acuity, and endothelial cell loss, and superior to penetrating keratoplasty in terms of early visual recovery and refractive stability, postoperative refractive outcomes, wound and suture-related complications, and intraoperative and late choroidal hemorrhage risk."

Several authors reported financial or consulting relationships with pharmaceutical companies.

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