title: Endothelial cell loss and graft survival after Descemet's stripping automated endothelial keratoplasty and penetrating keratoplasty.
abstract: OBJECTIVE
  We sought to compare endothelial cell (EC) loss and graft survival after Descemet's stripping automated endothelial keratoplasty (DSAEK) and conventional penetrating keratoplasty (PK) in Asian eyes.
  
  
  METHODS
  Retrospective, nested, cohort study.
  
  
  METHODS
  Consecutive patients who underwent DSAEK or PK with Fuchs' endothelial dystrophy or pseudophakic and aphakic bullous keratopathy (BK) at a single tertiary center from April 1, 2006, to April 1, 2008.
  
  
  METHODS
  Clinical data, and donor and recipient characteristics were recorded from our prospective cohort from the Singapore Corneal Transplant Study.
  
  
  METHODS
  Percent EC loss and graft survival up to 3 years.
  
  
  RESULTS
  There were no differences in baseline characteristics of patients comparing DSAEK and PK; there were more patients with BK (n = 141, 68.4%) than Fuchs' dystrophy. Percent EC loss was lower in DSAEK compared with PK at 1 (30 ± 22% vs 37 ± 25%; P = 0.045), 2 (36 ± 23% vs 45 ± 33%; P = 0.018), and 3 years (39 ± 24% vs 47 ± 28%; P = 0.022) postoperatively. Graft survival was comparable (log-rank P = 0.671) between DSAEK and PK at 1 (94% vs 90%), 2 (88% vs 85%), and 3 years (87% vs 85%).
  
  
  CONCLUSIONS
  Compared with PK, DSAEK resulted in lower EC loss with comparable cumulative graft survival rates for up to 3 years in patients with Fuchs' dystrophy and BK.
authors.affiliation: Singapore National Eye Centre, Singapore.
authors.forename: Marcus
authors.initials: M
authors.lastname: Ang
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
authors.forename: Fiona
authors.initials: F
authors.lastname: Lim
authors.forename: Saideep
authors.initials: S
authors.lastname: Bose
authors.forename: Hla Myint
authors.initials: HM
authors.lastname: Htoon
authors.forename: Donald
authors.initials: D
authors.lastname: Tan
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis*; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D012189:Retrospective Studies