TY - JOUR
T1 - Visual and subjective outcomes of phototherapeutic keratectomy after Descemet's stripping endothelial keratoplasty
AU - Lee, Bryan S.
AU - Hardten, David R.
PY - 2014/5/20
Y1 - 2014/5/20
N2 - Background: Patients with endothelial disease also often have scarring or surface corneal disease. This study examined the outcomes of phototherapeutic keratectomy (PTK) performed in patients with prior Descemet's stripping endothelial keratoplasty (DSEK). Methods: This retrospective case series examined all patients undergoing PTK after DSEK in a single private practice. The primary outcome was best-corrected visual acuity, with secondary outcomes of change in spherical equivalent versus targeted change, change in endothelial cell count, improvement in corneal topography, and subjective satisfaction with vision. Results: For the ten patients who met the inclusion criteria, mean best-corrected visual acuity improved from logarithm of the minimum angle of resolution (logMAR) 0.43 to 0.36 (P=0.24) at the most recent postoperative visit. PTK treatments that included a refractive component showed good predictability of 1.13 diopters spherical equivalent/diopter attempted. There was no evidence of a decrease in endothelial cell count from PTK, even with the use of mitomycin C (P=0.95). Subjectively, 80% of patients noted improvement in their vision. Conclusion: PTK after DSEK has the potential to improve patients' vision with high levels of patient satisfaction, even though many patients had significant ocular comorbidities. Surgeons should consider using PTK to treat anterior corneal pathology following DSEK.
AB - Background: Patients with endothelial disease also often have scarring or surface corneal disease. This study examined the outcomes of phototherapeutic keratectomy (PTK) performed in patients with prior Descemet's stripping endothelial keratoplasty (DSEK). Methods: This retrospective case series examined all patients undergoing PTK after DSEK in a single private practice. The primary outcome was best-corrected visual acuity, with secondary outcomes of change in spherical equivalent versus targeted change, change in endothelial cell count, improvement in corneal topography, and subjective satisfaction with vision. Results: For the ten patients who met the inclusion criteria, mean best-corrected visual acuity improved from logarithm of the minimum angle of resolution (logMAR) 0.43 to 0.36 (P=0.24) at the most recent postoperative visit. PTK treatments that included a refractive component showed good predictability of 1.13 diopters spherical equivalent/diopter attempted. There was no evidence of a decrease in endothelial cell count from PTK, even with the use of mitomycin C (P=0.95). Subjectively, 80% of patients noted improvement in their vision. Conclusion: PTK after DSEK has the potential to improve patients' vision with high levels of patient satisfaction, even though many patients had significant ocular comorbidities. Surgeons should consider using PTK to treat anterior corneal pathology following DSEK.
KW - Anterior basement membrane dystrophy
KW - Descemet's stripping endothelial keratoplasty
KW - Irregular astigmatism
KW - Phototherapeutic keratectomy
UR - http://www.scopus.com/inward/record.url?scp=84901369413&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84901369413&partnerID=8YFLogxK
U2 - 10.2147/OPTH.S63982
DO - 10.2147/OPTH.S63982
M3 - Article
AN - SCOPUS:84901369413
SN - 1177-5467
VL - 8
SP - 1011
EP - 1015
JO - Clinical Ophthalmology
JF - Clinical Ophthalmology
ER -