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A 10-year review of underlying diseases for endothelial keratoplasty (DSAEK/DMEK) in a tertiary referral hospital in Japan

Authors Nishino T, Kobayashi A, Yokogawa H, Mori N, Masaki T, Sugiyama K

Received 5 April 2018

Accepted for publication 31 May 2018

Published 6 August 2018 Volume 2018:12 Pages 1359—1365

DOI https://doi.org/10.2147/OPTH.S170263

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Tsubasa Nishino, Akira Kobayashi, Hideaki Yokogawa, Natsuko Mori, Toshinori Masaki, Kazuhisa Sugiyama

Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan

Purpose: To report a 10-year review of endothelial keratoplasty (EK) procedures, Descemet’s stripping automated endothelial keratoplasty (DSAEK) and Descemet’s membrane endothelial keratoplasty (DMEK), and underlying diseases at a tertiary referral hospital in Japan.
Study design: A single-center, retrospective case series.
Methods: We retrospectively reviewed all medical records of bullous keratopathy (BK) surgically treated by EK (DSAEK/DMEK) at Kanazawa University Hospital from January 2007 to December 2016. Changes or modifications to the annual number of EK procedures and underlying diseases were analyzed.
Results: During this period, 320 EK procedures (DSAEK: 288 cases, DMEK: 32 cases) were performed on 250 patients. Total annual EKs gradually increased from 19 to 45 cases between 2007 and 2016. The annual number of DSAEKs was stable, although the proportion of DSAEKs to other procedures decreased significantly as re-DSAEKs and DMEKs increased. BK after argon laser iridotomy (ALI) was the leading cause in 2007, followed by Fuchs’ endothelial dystrophy (FED) and failed penetrating keratoplasty. In 2016, BK after trabeculectomy (TLE) was most prevalent, followed by failed DSAEK, failed penetrating keratoplasty, and pseudophakic BK. The decreased ALI and FED, and increased BK after TLE and failed DSAEK were statistically significant.
Conclusion: The distribution of EK procedures (DSAEK/DMEK) and underlying diseases changed over 10 years at a tertiary referral hospital in Japan. The proportion of re-DSAEK and DMEK increased among all EK procedures. Most significantly, among the underlying diseases, decreased ALI and FED and increased TLE and failed DSAEK were observed. Extended multicenter analysis may further elucidate the changes in EK procedures and the causes of BK in Japan.

Keywords: argon laser iridotomy, trabeculectomy, reoperation, Fuchs’ endothelial dystrophy

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