title: Comparison of Long-Term Outcomes of Visual Function and Endothelial Cell Survival After Descemet Stripping Automated Endothelial Keratoplasty and Penetrating Keratoplasty Using Mixed-Effects Models.
abstract: OBJECTIVE
  To compare the long-term outcomes of visual function and endothelial cell survival after Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK).
  
  
  METHODS
  The cohort included 108 eyes from 97 patients who underwent primary PK and 85 eyes from 78 patients who underwent primary DSAEK at Miyata Eye Hospital in Japan. Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), endothelial cell density, and four components from Fourier harmonic analysis of topography data (spherical component, regular astigmatism component, asymmetry component, and higher-order irregularity component) were retrospectively compared between PK and DSAEK at each time point for 5 years using mixed-effects models. Subgroup analyses were performed to compare the effect of PK and DSAEK on visual acuity.
  
  
  RESULTS
  Average BSCVA was significantly better in the DSAEK group compared with that in the PK group both preoperatively and postoperatively. Subgroup analyses revealed that average changes in BSCVA from preoperative baseline in eyes with preoperative logarithm of the minimum angle of resolution BSCVA between 0.39 and 1.0 and between 1.3 and 2.0 were not significantly different between the PK and DSAEK groups at all postoperative time points. All components from Fourier harmonic analysis were significantly higher after PK than DSAEK at almost all postoperative time points. There were no significant differences in endothelial cell density between PK and DSAEK after 3 years.
  
  
  CONCLUSIONS
  PK and DSAEK provide similar recovery of BSCVA and endothelial cell survival at 5 years after surgery.
authors: *Miyata Eye Hospital, Miyakonojo, Japan;†Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; and‡Inouye Eye Hospital, Tokyo, Japan.
authors: Sosuke
authors: S
authors: Ishiyama
authors: Yosai
authors: Y
authors: Mori
authors: Ryohei
authors: R
authors: Nejima
authors: Toshihiko
authors: T
authors: Tokudome
authors: Shigeto
authors: S
authors: Shimmura
authors: Kazunori
authors: K
authors: Miyata
authors: Shiro
authors: S
authors: Amano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis; D019781:Corneal Topography; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005583:Fourier Analysis; D006084:Graft Rejection / Q000175:diagnosis; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*