gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

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Long-term refractive and visual outcome comparing penetrating keratoplasty only and the triple procedure in Fuchs' dystrophy

Meeting Abstract

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  • corresponding author C. Jacobi - Department of Ophthalmology, University Erlangen-Nürnberg
  • S. Das - ECOS Eye Hospital, Berhampur, Orissa, India
  • A. Langenbucher - Department of Ophthalmology, University Erlangen-Nürnberg
  • F.E. Kruse - Department of Ophthalmology, University Erlangen-Nürnberg
  • G.O.H. Naumann - Department of Ophthalmology, University Erlangen-Nürnberg
  • B. Seitz - Department of Ophthalmology, University Erlangen-Nürnberg

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.09.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog235.shtml

Published: September 22, 2004

© 2004 Jacobi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

To assess and compare the long-term refractive and visual outcome after penetrating keratoplasty (PK) only vs. the triple procedure in eyes with Fuchs' endothelial dystrophy.

Methods

Study design: retrospective, non-randomised, clinical, single centre study. 92 eyes were devided into Group 1 (28 eyes, which had undergone PK only, age: 62±13 years) and Group 2 (64 eyes, which had undergone the triple procedure, age: 69±10 years). In all eyes, a central trephination was performed (donor trephination from the epithelial side) using the 193 nm excimer laser along metal masks with 8 orientation teeth/notches. Hoffmann`s double-running cross stitch suture was applied in all eyes. Subjective refractometry, standard keratometry (Zeiss) and corneal topography analysis (TMS-1, Tomey) were performed. The results were compared between the two groups (Group 1 vs. Group 2) at various stages ("two sutures in"/"one suture out"/"two sutures out").

Results

Refractive cylinder [D] was 2.5/2.0/2.5 vs. 2.0/1.5/3.0, keratometric astigmatism [D] was 3.5/2.6/3.0 vs. 3.5/3.1/3.5. Keratometric central power [D] was 41.7/42.4/43.8 vs. 41.5/41.9/43.3 and topographic central power [D] was 42.3/43.6/43.7 vs. 42.6/41.8/44.3. The best- corrected visual acuity (BCVA) was 0.5/0.6/0.6 vs. 0.5/0.5/0.5. Spherical equivalent (SE) [D] was 0.0/0.0/-0.5 vs. -0.5/-0.5/-1.1. Surface regularity index (SRI) was 1.5/1.1/1.0 vs. 1.4/1.4/1.2 and surface asymmetry index (SAI) was 1.0/0.8/1.0 vs. 1.3/1.2/1.0. The proportion of regular and mild irregular keratometry mires was 44%/69%/68% vs. 29%/46%/66%. The differences between the two groups did not reach statistical significance at any of the stages.

Conclusions

Refractive and visual outcome after the triple procedure did not differ significantly from that after PK only. Therefore, we recommend the triple procedure in elderly patients with Fuchs`dystrophy and incipient cataract to avoid delayed visual rehabilitation and a second surgical procedure.