Outcomes of Resident-Performed Descemet's Stripping Automated Endothelial Keratoplasty

Tatyana R. Beketova; Margaret L. Pfeiffer; Alice Z. Chuang; Gene Kim

doi:10.1055/s-0037-1609035

Journal of Academic Ophthalmology, Table of Contents

CC-BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2017; 09(01): e26-e31
DOI: 10.1055/s-0037-1609035

Research Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Outcomes of Resident-Performed Descemet's Stripping Automated Endothelial Keratoplasty

Authors

Tatyana R. Beketova

¹Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
Margaret L. Pfeiffer

¹Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas

²Robert Cizik Eye Clinic, Houston, Texas

³Harris Health System, Houston, Texas
Alice Z. Chuang

¹Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
Gene Kim

¹Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas

²Robert Cizik Eye Clinic, Houston, Texas

³Harris Health System, Houston, Texas

Abstract

Purpose This article aimed to evaluate outcomes of resident-performed Descemet's stripping automated endothelial keratoplasty (DSAEK).

Methods This is a case series of patients who underwent DSAEK performed by PGY-4 ophthalmology residents at Lyndon B. Johnson Hospital from January 2013 to August 2016 staffed by a fellowship-trained cornea specialist. Patients with less than 1 month of follow-up were excluded. Demographics, baseline ocular characteristics, and intraoperative data were recorded. Vision and graft status were recorded at 1 week, 1 month, 3 months, and the last follow-up visits. Surgical failure was defined as graft detachment within 1 week of surgery and/or primary graft failure within 3 months of surgery.

Results Eighteen eyes of 18 patients who followed up for 14.9 months (±12.9) were included. Mean age of patients was 60.9 years (±13.2). Indications for DSAEK included pseudophakic bullous keratopathy (10), Fuchs endothelial dystrophy (4), and other causes of endothelial dysfunction (4). Eleven (61%) eyes had prior ocular surgery, and 7 (39%) had prior glaucoma surgery. There were no postoperative graft detachments and two (11%) primary graft failures. There was one primary graft failure in a glaucoma patient. Of the 16 graft successes, logMAR visual acuity improved by 0.46 logMAR (±0.73) from baseline.

Conclusion With appropriate staffing by an experienced cornea surgeon, DSAEK with residents as the primary surgeons is a safe and effective procedure with reasonably good outcomes.

Keywords

cornea - resident - DSAEK

Full Text

References

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