title: Endothelial keratoplasty without Descemet stripping after failed penetrating keratoplasty.
abstract: OBJECTIVE
  To evaluate outcomes of endothelial keratoplasty (EK) without Descemet membrane stripping for treatment of failed penetrating keratoplasty (PKP).
  
  
  METHODS
  Retrospective cohort study of all eyes that underwent EK without Descemet membrane stripping for failed PKP at one institution between May 2008 and June 2010, with follow-up to 12 months. Main outcome measures were best-corrected visual acuity (BCVA), dislocation rate, and graft failure.
  
  
  RESULTS
  Twenty-two eyes of 22 patients underwent non-Descemet stripping EK with a mean follow-up of 8.8 months (±3.41; range, 3-12 months). The mean preoperative BCVA was logarithm of the minimum angle of resolution (logMAR) 1.43 (±0.72; range, 0.3-3; Snellen, 20/537; N = 22). The mean postoperative BCVA was logMAR 0.97 (±0.88; range, 0-3; N = 21) at 1 month, 0.76 logMAR (±0.74; range, 0.1-3; N = 21) at 3 months, 0.75 (±0.77; range, 0-3; N = 17) at 6 months, and logMAR 0.55 (±0.38; range, 0.18-1; Snellen, 20/70; N = 9) at 1 year. Eight eyes (36.6%) had graft dislocations requiring one rebubbling procedure in 6 of 8 eyes and 2 rebubblings in the other 2 eyes. All grafts were successfully reattached. Graft failure occurred in 2 of 22 eyes (9%), with 1 eye (5%) undergoing repeat EK and 1 eye (5%) undergoing PKP.
  
  
  CONCLUSIONS
  EK without Descemet membrane stripping is an effective option for management of eyes with failed PKP and may be a preferable alternative to a repeat PKP.
authors.affiliation: Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Heitor de Paula
authors.forename: Roheena
authors.initials: R
authors.lastname: Kamyar
authors.forename: Roni M
authors.initials: RM
authors.lastname: Shtein
authors.forename: Alan
authors.initials: A
authors.lastname: Sugar
authors.forename: Shahzad I
authors.initials: SI
authors.lastname: Mian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000502:physiology*; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D003886:Descemet Membrane / Q000601:surgery; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology