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Newer cornea transplant surgery shows short- and long-term promise
Date:2/22/2010

One year post-surgery, patients who underwent Descemet's stripping automated endothelial keratoplasty (DSAEK) experienced greater cell loss overall compared to those who underwent penetrating keratoplasty (PKP), according to a new analysis of data collected from the Cornea Donor Study (CDS) Investigator Group's 2008 Specular Microscopy Ancillary Study (SMAS). However, the study, published in the March issue of Ophthalmology, showed that cell loss in DSAEK patients plateaued more quickly than in those who underwent PKP. The two procedures are alternative methods of corneal transplant surgery for diseases affecting the back cell layer of the cornea, the endothelium.

Both the operation and recovery time associated with DSAEK are shorter because the 360-degree PKP wound is larger, weaker and more prone to rupture. PKP, a procedure that has been actively performed for more than 50 years, involves replacing all the layers of the cornea with healthy donor tissue. DSAEK is a newer procedure, developed within the last five years, by which the diseased, endotheliuma layer of cells that maintains the cornea's clarity and thinnessis replaced with a piece of only healthy donor endothelial tissue. "There is no question of the immediate benefits of DSAEK," says senior author of the study Jonathan H. Lass, M.D., Professor and Chair of the Department of Ophthalmology and Visual Sciences at Case Western Reserve University School of Medicine and University Hospitals Eye Institute. These benefits include greater eye integrity due to a smaller wound; quicker recovery with less visual distortion; and decreased severity in postoperative surface problems, such as dry eye.

According to Dr. Lass, the present study suggests the potential long-term benefits of DSAEK may outweigh the initial cell loss. "The fact that the transplants are less susceptible to trauma is promising for this growing procedure. DSAEK patients are seeing more quickly than PKP patients and
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Contact: Jessica Studeny
jessica.studeny@case.edu
216-368-4692
Case Western Reserve University
Source:Eurekalert

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