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Secondary endothelial keratoplasty: a narrative review of the outcomes of secondary corneal endothelial allografts

2021-03Journal article Open access
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dc.contributor.authorMoura-Coelho, Nuno
dc.contributor.authorCunha, João Paulo
dc.contributor.authorMorral, Merce
dc.contributor.authorGris, Oscar
dc.contributor.authorManero, Felicidad
dc.contributor.authorGüell, José
dc.date.accessioned2021-08-04T14:54:56Z
dc.date.available2024-08-04T00:30:20Z
dc.date.issued2021-03
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 27th September 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: 27 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 EK. Twelve studies compared visual outcomes between primary and secondary EK, reporting conflicting findings. Sixteen studies reported endothelial cell loss rates (%ECL) after secondary EK, and only one study reported significantly increased %ECL 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 one study found a higher median number of complications. However, two 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/acceptedVersionpt_PT
dc.identifier.citationMoura-Coelho N, Cunha JP (João Paulo), Morral M, Gris O, Manero F, Güell J. Secondary endothelial keratoplasty: a narrative review of the outcomes of secondary corneal endothelial allografts. Transplantation. 2021;105(12):E347-65.pt_PT
dc.identifier.doi10.1097/TP.0000000000003735pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/13624
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherLippincott Williams & Wilkinspt_PT
dc.relation.publisherversionhttps://journals.lww.com/transplantjournal/Abstract/9000/Secondary_Endothelial_Keratoplasty___A_Narrative.95322.aspxpt_PT
dc.subjectOphthalmologypt_PT
dc.subjectOrthopticspt_PT
dc.subjectSecondary endothelial keratoplastypt_PT
dc.subjectSecondary corneal endothelial allograftspt_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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