Endothelial corneal transplants: indications,clinical profile and surgical outcomes in a tertiary care hospital |
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| Affiliation: | 1. Classified Specialist (Ophthalmology) and Anterior Segment Surgeon, Army Hospital (R&R), New Delhi, India;2. Consultant, Eye Care and Laser Center, New Delhi, India;3. Consultant, Centre for Sight, Dwarka, New Delhi, India;4. Senior Adviser & Head (Ophthalmology) and Vitreoretinal Surgeon, Army Hospital (R&R), New Delhi, India;5. Assistant Professor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India;6. Senior Advisor (Ophthalmology) and Vitreoretinal Surgeon, Army Hospital (R&R), New Delhi, India;7. Senior Advisor (Ophthalmology), Command Hospital (Air Force), Bengaluru, India;1. Classified Specialist (Respiratory Medicine), Military Hospital (Cardio Thoracic Centre), Pune 411040, India;2. Graded Specialist (Radiology), Command Hospital (Southern Command), Pune 411040, India;3. Senior Advisor (Medicine & Respiratory Medicine) & Head, Military Hospital (Cardio Thoracic Centre), Pune 411040, India;4. Consultant (Medicine & Respiratory Medicine) & Head, Army Hospital (R&R), Delhi 110010, India;1. Classified Specialist (Orthodontics), Department of Dental Research & Implantology, Institute of Nuclear Medicine and Allied Sciences (INMAS), Timarpur, Delhi 110054, India;2. PhD Research Scholar, Department of Dental Research & Implantology, Institute of Nuclear Medicine and Allied Sciences (INMAS), Timarpur, Delhi 110054, India;3. Department of Biochemistry, Army College of Medical Sciences (ACMS), Delhi Cantt, India;4. Project Dental Officer, Department of Dental Research & Implantology, Institute of Nuclear Medicine and Allied Sciences (INMAS), Timarpur, Delhi, India;5. Scientist ‘G’ & Addl Director, Head, Division of Stem Cell and Gene Therapy Research, Institute of Nuclear Medicine and Allied Sciences (INMAS), Timarpur, Delhi, India;6. Director General Dental Services (DGDS), IHQ of MoD, L Block, New Delhi, India;7. Scientist ‘H’ & Director, Institute of Nuclear Medicine and Allied Sciences (INMAS), Ministry of Defence, Govt of India, Timarpur, Delhi, India;8. Senior Consultant, Haemato-Oncology & Bone Marrow Transplant, Comprehensive Blood & Cancer Center (CBCC), 632, C-1, Ansals Palam Vihar, Carterpuri, Gurgaon 122017, India;1. Graded Specialist (Community Medicine), Officer Commanding, Station Health Organization, Jalandhar Cantt, India;2. Lecturer in Statistics and Demography, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India;3. Scientist ‘F’, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India;4. Director, Armed Forces Medical Services (Health), O/o DGAFMS, Ministry of Defence, New Delhi, India;1. Commandant, Military Hospital, Mhow, India;2. Col Trg, AMC Centre & College, Lucknow, India;3. Professor & Head (Medicine) & Endocrinology, AIIMS, Jodhpur, India;4. Graded Specialist (Biochemistry), Command Hospital (Central Command), Lucknow, India;5. Associate Professor (Physiology), Career Institute of Medical Sciences, Lucknow, India;1. Assistant Professor, Department of Dermatology & Ven, Armed Forces Medical College, Pune 411040, India;2. Resident, Department of Dermatology & Ven, Armed Forces Medical College, Pune 411040, India;3. Senior Advisor (Dermatology), Base Hospital Lucknow, India;4. Professor & Head (Dermatology), Command Hospital (Southern Command), Pune 411040, India;1. Senior Advisor (Nephrology), Army Hospital (Research & Referral), Delhi, India;2. Senior Resident (Nephrology), Army Hospital (Research & Referral), Delhi, India;3. Classified Specialist, (Nephrology), Army Hospital (Research & Referral), Delhi, India |
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| Abstract: | BackgroundEndothelial keratoplasties have become the surgical procedure of choice over full thickness penetrating keratoplasty for corneal decompensation because of endothelial dysfunction.MethodsA retrospective data review was performed from February 2016 to April 2017 for all the patients who underwent endothelial keratoplasty in a tertiary care center for Indian Armed Forces.ResultsA total of 161 corneal transplants were performed; endothelial keratoplasties accounted for 34 (21.1%) transplants. Most common indication was pseudophakic/aphakic bullous keratopathy followed by Ahmed glaucoma valve–related corneal decompensation and Fuchs' corneal dystrophy, respectively. Mean preoperative corneal thickness was 845.96 ± 106.9 microns. Mean lenticule thickness was 131.55 ± 42.47 microns with microkeratome for descemet stripping automated endothelial keratoplasty (DSAEK) and 174 ± 70.4 microns manually for descemet stripping endothelial keratoplasty (DSEK). Mean preoperative best-corrected visual acuity (BCVA) was 1.65 LogMAR (Snellen equivalent in meters 2/60 approx) which significantly improved to 0.82 LogMAR (Snellen equivalent in meters 6/36 approx) after surgery. In the DSAEK group, BCVA improved from 1.61 to 0.7 LogMAR, whereas in the DSEK group, the visual acuity improved from 1.7 to 0.94 LogMAR at one-month postoperative period. Postoperatively, two patients had graft detachment and had to undergo repeat DSAEK.ConclusionStudy results suggest the similar trends in our tertiary care hospital as in other most advanced ophthalmic centers around the world for adoption of newer techniques of lamellar corneal transplants and their outcomes. |
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| Keywords: | Endothelial keratoplasty Microkeratome Corneal decompensation Ahmed glaucoma valve Lamellar keratoplasty |
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