Donor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes

Donor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes

Marcus Ang1,2, Hla M Htoon1,2, Howard Y Cajucom-Uy1,2, Donald Tan1–3, Jodhbir S Mehta1–41Singapore National Eye Centre, Bukit Merah, 2Singapore Eye Research Institute, Bukit Merah, 3Department of Ophthalmology, Yong Yoo Lin School of Medicine, National University of Singa...

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Autores principales: Ang M, Htoon HM, Cajucom-Uy HY, Tan D, Mehta JS
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Lenguaje:EN
Publicado: Dove Medical Press 2011
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Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/bb0059d7c75a45e6ad89100bf40d7b47
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spelling oai:doaj.org-article:bb0059d7c75a45e6ad89100bf40d7b472021-12-02T00:45:10ZDonor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes1177-54671177-5483https://doaj.org/article/bb0059d7c75a45e6ad89100bf40d7b472011-10-01T00:00:00Zhttp://www.dovepress.com/donor-and-surgical-risk-factors-for-primary-graft-failure-following-de-a8484https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Marcus Ang1,2, Hla M Htoon1,2, Howard Y Cajucom-Uy1,2, Donald Tan1–3, Jodhbir S Mehta1–41Singapore National Eye Centre, Bukit Merah, 2Singapore Eye Research Institute, Bukit Merah, 3Department of Ophthalmology, Yong Yoo Lin School of Medicine, National University of Singapore, Queenstown, 4Duke-NUS Graduate Medical School, Outram, SingaporeBackground: Descemet's stripping automated endothelial keratoplasty (DSAEK) has been shown to have superior refractive and visual results compared with penetrating keratoplasty, but higher rates of primary graft failure (PGF). This paper presents donor and surgical risk factors for PGF in DSAEK cases in Asian eyes.Design: Retrospective case-control study.Participants: All consecutive patients who underwent DSAEK at a tertiary referral teaching hospital from March 2006–December 2008.Methods: Donor details analyzed were: age of donor, cause of donor death, death to harvesting time, donor storage time, distribution distance of tissue, preoperative endothelial cell count. Surgical factors analyzed were: donor diameter, donor thickness, and method of donor insertion. These risk factors in cases of PGF were compared with patients with successful DSAEK as the control group.Main outcome measure: PGF.Results: A total of 124 DSAEK procedures were performed. Six DSAEK procedures (five eyes of five patients; one eye with two failures) resulted in PGF (4.8%). Significant risk factors were found for PGF to include graft insertion using a folding technique (odds ratio [OR], 34.03; 95% confidence interval [CI], 3.75–314.32; P = 0.0017) and a small donor diameter (OR, 39.94; 95% CI, 2.18–732.17; P = 0.013).Conclusion: The results of this study suggest that in Asian eyes with shallow anterior chambers, surgical trauma relating to the technique of donor insertion, and the use of a small donor are major risk factors for PGF following DSAEK.Keywords: DSAEK, PGF, penetrating keratoplastyAng MHtoon HMCajucom-Uy HYTan DMehta JSDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2011, Iss default, Pp 1503-1508 (2011)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Ang M
Htoon HM
Cajucom-Uy HY
Tan D
Mehta JS
Donor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes
description Marcus Ang1,2, Hla M Htoon1,2, Howard Y Cajucom-Uy1,2, Donald Tan1–3, Jodhbir S Mehta1–41Singapore National Eye Centre, Bukit Merah, 2Singapore Eye Research Institute, Bukit Merah, 3Department of Ophthalmology, Yong Yoo Lin School of Medicine, National University of Singapore, Queenstown, 4Duke-NUS Graduate Medical School, Outram, SingaporeBackground: Descemet's stripping automated endothelial keratoplasty (DSAEK) has been shown to have superior refractive and visual results compared with penetrating keratoplasty, but higher rates of primary graft failure (PGF). This paper presents donor and surgical risk factors for PGF in DSAEK cases in Asian eyes.Design: Retrospective case-control study.Participants: All consecutive patients who underwent DSAEK at a tertiary referral teaching hospital from March 2006–December 2008.Methods: Donor details analyzed were: age of donor, cause of donor death, death to harvesting time, donor storage time, distribution distance of tissue, preoperative endothelial cell count. Surgical factors analyzed were: donor diameter, donor thickness, and method of donor insertion. These risk factors in cases of PGF were compared with patients with successful DSAEK as the control group.Main outcome measure: PGF.Results: A total of 124 DSAEK procedures were performed. Six DSAEK procedures (five eyes of five patients; one eye with two failures) resulted in PGF (4.8%). Significant risk factors were found for PGF to include graft insertion using a folding technique (odds ratio [OR], 34.03; 95% confidence interval [CI], 3.75–314.32; P = 0.0017) and a small donor diameter (OR, 39.94; 95% CI, 2.18–732.17; P = 0.013).Conclusion: The results of this study suggest that in Asian eyes with shallow anterior chambers, surgical trauma relating to the technique of donor insertion, and the use of a small donor are major risk factors for PGF following DSAEK.Keywords: DSAEK, PGF, penetrating keratoplasty
format article
author Ang M
Htoon HM
Cajucom-Uy HY
Tan D
Mehta JS
author_facet Ang M
Htoon HM
Cajucom-Uy HY
Tan D
Mehta JS
author_sort Ang M
title Donor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes
title_short Donor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes
title_full Donor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes
title_fullStr Donor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes
title_full_unstemmed Donor and surgical risk factors for primary graft failure following Descemet's stripping automated endothelial keratoplasty in Asian eyes
title_sort donor and surgical risk factors for primary graft failure following descemet's stripping automated endothelial keratoplasty in asian eyes
publisher Dove Medical Press
publishDate 2011
url https://doaj.org/article/bb0059d7c75a45e6ad89100bf40d7b47
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