title: [Descemet's stripping automated endothelial keratoplasty for endothelial failure after penetrating keratoplasty].
abstract: OBJECTIVE
  To evaluate the outcome of Descemet's stripping automated endothelial keratoplasty (DSAEK) in eyes with endothelial failure after penetrating keratoplasty (PK).
  
  
  METHODS
  DSAEK was performed on 13 eyes of 13 patients with failed PK. Their mean age was 73.2 years. Evaluation of visual acuity, subjective astigmatism, corneal endothelial cell density, and complications was performed.
  
  
  RESULTS
  In four eyes, PK was performed after previous surgery for hypometropia by Sato's anterior-posterior radial keratotomy. Mean followup time was 20.3 +/- 8.6 months. Mean logarithmic minimum angle of resolution (logMAR) visual acuity was 1.92 before DSAEK and 0.89 at final follow-up. Mean subjective astigmatism was 5.10 +/- 3.09D before surgery and 7.25 +/- 4.16 D at 6 months postoperatively. Mean corneal endothelial cell density at 6, 12, 24 months after DSAEK was 42.8%, 51.3%, 72.1%, respectively. Regarding postoperative complications, air was reinjected in four eyes, persistent epithelial defect and rejection occurred in one eye each, and PK was repeated in three eyes.
  
  
  CONCLUSIONS
  DSAEK rapidly improved visual acuity after failed PK, but some eyes required repeat PK. Eligibility criteria for DSAEK after failed PK should be established.
authors: Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan. satoru-n@juntendo.ac.jp
authors: Satoru
authors: S
authors: Nakatani
authors: Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
authors: Akira
authors: A
authors: Murakami
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016039:Corneal Transplantation / Q000379:methods; D003886:Descemet Membrane / Q000473:pathology / Q000601:surgery*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology*