Long term Results of Endothelial Keratoplasty in patients with failed penetrating Keratoplasty Maoz D. Amiran, MD, Raneen Shehadeh-Mashor, MD, Marie Eve Légaré, MD, Alphonso Iovieno, MD, Allan R. Slomovic, MA, MD, FRCSC & David S. Rootman, MD, FRCSC Department Of Ophthalmology Toronto Western Hospital University of Toronto Toronto, Ontario, Canada The authors have no financial interest in the subject matter of this poster Submissions Number: 663

Purpose To report the long term results of Descemet Stripping and Automated Endothelial Keratoplasty (DSAEK) in patients with failed penetrating keratoplasty (PKP)

Patients & methods A retrospective, consecutive, non-randomized cohort study, IRB approved Undertaken in the cornea clinic at the Toronto Western Hospital, Toronto, Ontario, Canada All records of all patients who had failed PKP and underwent DSAEK were reviewed

Results Study group, 10 pts M / F: 6 / 4 Mean Age: 71.6 y/o (Range 53-89) OD / OD: 3 / 7 All patients had PKP 6.92 years prior to DSAEK (Range 2.75-14.9) One patient underwent cataract extraction with IOL implantation at the same time with DSAEK Mean follow-up: 18.4 month (Range 3-29) .

Results Study group, 10 pts Reasons for original PKP Number of Pts. PBK / ABK 4 Fuch's dystrophy 2 Glaucoma with shunt in A/C ICE syndrome 1 Trachoma scars .

Results Post. Operative period Descemet membrane was stripped in all cases, no complication during surgery IOP rise in the postoperative period was noted in three cases

Results At the end of F/U .

Results 2 years post DSAEK .

Results Best Spectacle Corrected Visual Acuity (BSCVA) Log MAR (Range) Preoperative 2.22 ( 1.5 – 3 ) Three month after surgery 1.38 ( 0.3 – 3 ) End of follow-up 1.63 ( 0.3 – 3 ) Vision is limited in some patients by: Advanced glaucoma Macular scar

Conclusions Doing a DSAEK operation for failed PKP is not more complicated then regular DSAEK operation The rate of postoperative detachment and complication is higher