Clinical Outcomes of Penetrating Keratoplasty and Descemet Stripping Automated Endothelial Keratoplasty in Asian Population with American Corneas

• Published in: International journal of environmental research and public health Vol. 16; no. 22; p. 4547
• Main Authors: Hsiao, Fang-Chi, Chen, Po-Yuan, Meir, Yaa-Jyuhn James, Tan, Hsin-Yuan, Hsiao, Ching-Hsi, Lin, Hsin-Chiung, Ma, David Hui-Kang, Yeh, Lung-Kun, Wu, Wei-Chi, Chen, Hung-Chi
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 17.11.2019; MDPI
• Subjects: Adult; Aged; Asian Continental Ancestry Group; Automation; Banks; Cardiovascular disease; Cardiovascular diseases; Cell density; Clinical outcomes; Cornea; Corneal Diseases - surgery; Coronary artery disease; Descemet Stripping Endothelial Keratoplasty; Endothelial cells; Failure; Family medical history; Female; Glaucoma; Graft Survival; Grafts; Heart; Heart diseases; Hospitals; Humans; Hypertension; Ischemia; Keratoplasty, Penetrating; Male; Medical records; Middle Aged; Regression analysis; Retrospective Studies; Statistical analysis; Subgroups; Surgeons; Survival analysis; Tissue Donors; Transplants & implants; Treatment Outcome; United States; Viral infections; Visual Acuity; United States; Taiwan; PK; long term clinical outcomes; DSAEK; imported corneas
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph16224547

To determine the comparative efficacy and safety of penetrating keratoplasty PK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the Asian population receiving imported donor corneas, our single-center retrospective study provides analysis supporting the transition from PK to DSAEK in the Asian population using imported American donor corneas. We analyzed 259 patients with 241 and 57 cases of PK and DSAEK respectively during 2008 to 2017 using imported corneas at Chang Gung Memorial Hospital, Linkou, Taiwan. In terms of long-term graft survival analysis, there was no difference between PK and DSAEK (log-rank = 0.386, HR = 0.920, 95% CI: [0.641-1.380]). However, Cox proportional regression analysis revealed that corneal survival rate of DSAEK group in the first 100 days after transplantation was inferior than that of PK group (log-rank < 0.001, HR = 2.733, 95% CI: [1.501-4.977])]. Despite the inferior survival rate, there were significantly less neovascularization and Descemet membrane folds in the DSAEK group. Importantly, the non-complication rate of DSAEK was much higher than that of PK with significant difference (PK, 25.7% vs DSAEK 42.0%, = 0.022). Collectively, DSAEK is suggested as an alternative surgical modality in Asian patients using imported American donor corneas because of less complication, and no difference in long-term corneal graft survival rates between PK and DSAEK.