Descemet Stripping Endothelial Keratoplasty for Fuchs' Endothelial Corneal Dystrophy: Five-Year Results of a Prospective Study.

摘要: Purpose To determine 5-year outcomes of Descemet stripping endothelial keratoplasty (DSEK) for Fuchs' corneal dystrophy (FECD). Design Prospective cohort study. Participants Fifty-two eyes 45 subjects with FECD undergoing primary DSEK. Methods Subjects were examined before and at fixed intervals through 60 months after At each visit, graft survival was determined by slit-lamp examination; best spectacle-corrected visual acuity (BSCVA) measured using the electronic Early Treatment Diabetic Retinopathy Study (ETDRS) protocol; total anterior higher-order aberrations (HOAs) derived from topography; backscatter, thickness, cell density confocal microscopy images. Corneal thickness also ultrasonic pachymetry. Changes DSEK analyzed generalized estimating equation models. Main Outcome Measures Best-corrected acuity, HOAs, loss, backscatter. Results Complete 60-month follow-up possible in 34 eyes. Mean BSCVA±standard deviation improved 0.45±0.19 logarithm minimum angle resolution (logMAR) (Snellen equivalent, 20/56) to 0.09±0.13 logMAR 20/25) 5 years ( P ≤ 0.002). Six grafts failed, which 4 (iatrogenic); mean loss±standard 55±15% years. Conclusions Between 1 DSEK, BSCVA continues to improve such that years, more than half see better 20/25 a 700 μm. Improvement vision is accompanied continued reduction haze aberrations, suggesting ongoing remodeling cornea restoration function.