title: Endothelial keratoplasty: improvement of vision after healthy donor tissue exchange.
abstract: OBJECTIVE
  To report 3 cases of graft exchange by using a microkeratome-prepared donor tissue in place of a manually prepared donor tissue for inadequate postoperative visual acuity after deep lamellar endothelial keratoplasty and to discuss possible etiologies.
  
  
  METHODS
  Prospective, observational case series. The patients were 3 consecutive patients who underwent endothelial graft replacement for unsatisfactory vision after initial deep lamellar endothelial keratoplasty. This is a review of clinical findings in 3 cases of endothelial keratoplasty that underwent graft exchange for unacceptable vision after deep lamellar endothelial keratoplasty.
  
  
  RESULTS
  Two patients benefited from graft exchange by using a microkeratome-prepared donor in place of a manually prepared donor with improvement in best spectacle-corrected visual acuity and 1 did not because of recipient bed irregularities. Vision improved in this patient with penetrating keratoplasty.
  
  
  CONCLUSIONS
  Endothelial keratoplasty results in rapid visual recovery and excellent vision. However, fewer eyes achieve 20/20 vision than with full-thickness penetrating keratoplasty. This report shows that some patients with suboptimal vision after endothelial keratoplasty felt to be caused by interface optical problems may benefit from either graft exchange or penetrating keratoplasty.
authors: Devers Eye Institute, Portland, OR 97210, USA. eschen37@hotmail.com
authors: Edwin S
authors: ES
authors: Chen
authors: Neda
authors: N
authors: Shamie
authors: Mark A
authors: MA
authors: Terry
authors: Karen L
authors: KL
authors: Hoar
mesh_terms: D000368:Aged; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods* / Q000502:physiology; D003886:Descemet Membrane / Q000502:physiology / Q000601:surgery*; D004728:Endothelium, Corneal / Q000502:physiology / Q000637:transplantation*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014019:Tissue Donors; D014792:Visual Acuity / Q000502:physiology*