title: Evaluation of Endothelial Pump Function in Fuchs Endothelial Dystrophy Before and After Endothelial Keratoplasty.
abstract: OBJECTIVE
  To evaluate the endothelial pump function in vivo after Descemet stripping automated endothelial keratoplasty (DSAEK).
  
  
  METHODS
  In a prospective controlled trial, a group of 17 patients with Fuchs endothelial corneal dystrophy (FECD) eligible for DSAEK surgery and a group of 15 patients with cataract but with normal corneas eligible for cataract surgery (controls) were formed. A low oxygen-permeable contact lens was used to induce corneal edema. Changes in central corneal thickness were monitored as an indirect measure of endothelial cell pump function. Experiments were performed before surgery and repeated 12 months after surgery.
  
  
  RESULTS
  Comparing the FECD and control groups before surgery, there was 24.8% (13.5-36.1) more edema in the FECD group after 2 hours (P < 0.001) and 19.9% (8.6-31.3) more edema in the FECD group after 3 hours (P < 0.001). In the FECD group, there was 15% (3.1-26.9) less edema after DSAEK than before surgery (P = 0.015) after 3 hours. Comparing the DSAEK-treated eyes with the control eyes 12 months after surgery; there was 12.8% (3.5-22.1) more edema in the DSAEK group after 2 hours (P = 0.007), but after 3 hours, the percentages of edema were similar (P = 0.11).
  
  
  CONCLUSIONS
  Twelve months after DSAEK surgery, the grafted endothelium cleared the induced edema as fast as the control group, indicating a viable and near-normal endothelial pump function. However, significant differences in the deswelling patterns were detected, which may be caused by the added corneal stroma after DSAEK.
authors.affiliation: *Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark; and †Section of Biostatistics, Department of Public Health, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Esben
authors.initials: E
authors.lastname: Nielsen
authors.forename: Anders
authors.initials: A
authors.lastname: Ivarsen
authors.forename: Mogens
authors.initials: M
authors.lastname: Erlandsen
authors.forename: Jesper
authors.initials: J
authors.lastname: Hjortdal
mesh_terms: D000368:Aged; D002386:Cataract; D002387:Cataract Extraction; D015715:Corneal Edema / Q000503:physiopathology; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000502:physiology*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D016623:Ion Pumps / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000254:Sodium-Potassium-Exchanging ATPase / Q000378:metabolism
chemical_list: D016623:Ion Pumps; D000254:Sodium-Potassium-Exchanging ATPase