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Secondary Endothelial Keratoplasty—A Narrative Review of the Outcomes of Secondary Corneal Endothelial Allografts

2021Journal article Open access
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dc.contributor.authorMoura-Coelho, N
dc.contributor.authorCunha, JP
dc.contributor.authorMorral, M
dc.contributor.authorGris, O
dc.contributor.authorManero, F
dc.contributor.authorGüell, JL
dc.date.accessioned2023-02-05T17:27:44Z
dc.date.available2023-02-05T17:27:44Z
dc.date.issued2021
dc.description.abstractBackground: We review the literature on the efficacy and safety outcomes of secondary Descemet stripping endothelial keratoplasty (DSEK) and Descemet membrane endothelial keratoplasty (DMEK). Methods: Literature search of English-written publications up to September 27, 2020 in PubMed database, using the terms "endothelial keratoplasty" in combination with keywords "secondary" or "repeat." In addition, we manually searched the references of the primary articles. Results: Twenty-seven studies (n = 651 eyes) were retained and reviewed, including 10 studies on repeat DSEK, 8 studies on repeat DMEK, 6 studies of DMEK following DSEK, and 3 studies of DSEK after failed DMEK. All studies reported significant improvement in visual acuity after secondary endothelial keratoplasty (EK). Twelve studies compared visual outcomes between primary and secondary EK, reporting conflicting findings. Sixteen studies reported endothelial cell loss rates after secondary EK, and only 1 study reported significantly increased endothelial cell loss rates compared with primary EK. Allograft rejection episodes occurred in 1.8% of eyes (range, 0%-50%). Six studies compared complication rates between primary and secondary EK eyes, and only 1 study found a higher median number of complications. However, 2 studies reported higher regraft failure rates compared with primary EK eyes. Conclusions: Secondary EK is surgically feasible and renders significant visual improvement after failed primary EK, although it is not clear whether visual outcomes and allograft survival are comparable with primary EK, raising the question of whether secondary EK eyes are "low risk" as primary EK eyes. Further larger, prospective studies are encouraged to obtain additional quality data on secondary corneal endothelial allotransplantation.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationTransplantation . 2021 Dec 1;105(12):e347-e365.pt_PT
dc.identifier.doi10.1097/TP.0000000000003735pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/43627
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectQueratoplastia Endotelial com Remoção da Lâmina Limitante Posteriorpt_PT
dc.subjectDescemet Stripping Endothelial Keratoplastypt_PT
dc.titleSecondary Endothelial Keratoplasty—A Narrative Review of the Outcomes of Secondary Corneal Endothelial Allograftspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPagee365pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPagee347pt_PT
oaire.citation.titleTransplantationpt_PT
oaire.citation.volume105pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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