title: Three-year outcome of Descemet stripping automated endothelial keratoplasty for bullous keratopathy after argon laser iridotomy.
abstract: OBJECTIVE
  The aim of this study was to evaluate the 3-year outcome of Descemet stripping automated endothelial keratoplasty (DSAEK) for the treatment of bullous keratopathy secondary to argon laser iridotomy (ALI).
  
  
  METHODS
  A total of 22 consecutive patients (22 eyes) with ALI who underwent DSAEK were retrospectively analyzed. Best spectacle-corrected visual acuity (BSCVA), endothelial cell density, and complications were investigated over 3 years postoperatively. The outcome of DSAEK was also compared between the ALI group and 21 other patients with Fuchs endothelial dystrophy (FED) or pseudophakic bullous keratopathy (PBK) (FED/PBK group).
  
  
  RESULTS
  The median BSCVA improved from logarithm of the minimum angle of resolution 1.40 before DSAEK to 0.30 at 6 months, 0.30 at 12 months, 0.22 at 24 months, and 0.15 at 36 months after surgery. The median endothelial cell loss was 20.3% at 6 months, 18.4% at 12 months, 32.5% at 24 months, and 46.5% at 36 months. Comparison of the ALI group with the FED/PBK group showed no significant difference in the BSCVA or endothelial cell density. Rejection affected 9.1% of the ALI group versus 0% of the FED/PBK group (P = 0.49), the graft dislocation rate was 0% versus 9.5% (P = 0.23), and posterior synechiae were found in 31.8% versus 4.8% (P = 0.046).
  
  
  CONCLUSIONS
  The 3-year outcome of DSAEK for bullous keratopathy after ALI was excellent. However, caution should be exercised in patients with a history of ALI to avoid posterior synechiae after DSAEK.
authors.affiliation: Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Nakatani
authors.forename: Akira
authors.initials: A
authors.lastname: Murakami
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057908:Argon Plasma Coagulation / Q000009:adverse effects*; D001768:Blister / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D002452:Cell Count; D003316:Corneal Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D032801:Iridectomy / Q000009:adverse effects*; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology