Abstract:
Purpose: Evaluation of aqueous flare in patients after Descemet's Stripping Endothelial
Keratoplasty (DSEK) and Penetrating Keratoplasty (PK) performed of various indications.
Material and methods: In a prospective study 17 eyes in 16 patients were examined. First group
consisted of 8 eyes after DSEK, second: 9 eyes after PK. The first procedure was performed of
Fuch’s dystrophy - 4 eyes, bullous keratopathy – 4 eyes. The indications in the second were as
follows: keratoconus – 2 eyes, corneal cicatrix without neovascularization – 3 eyes, endangering
corneal perforation – 4 eyes. Examined group mean age was respectively 67 and 69 years. The
overall examining time was six months after the surgery. In the paperaqueous flare was evaluated
in the anterior chamber in 1st, 3rd and 6th month after keratoplasty in FM-600 Laser Flare Kowa.
Abovementioned device function is based on emission and detection of light produced by diode
laser. Keratoplasty was performed in general (No 9) or in local peribulbar (No 8) anaesthesia.
Results: Mean aqueous flarein 1st, 3rd, and 6th month after keratoplasty is significantly lower after
DSEK (14,46 +/- 4,70 ph/ms; 10,64 +/- 2,91 ph/ms; 5,98 +/- 2,53 ph/ms) in comparison with PK
(18,50 +/- 5,82 ph/ms; 15,04 +/- 6,38 ph/ms; 10,68 +/- 3,83 ph/ms). In 6 months observation the
mean flare value in DSEK was decreased twice in comparison with PK. Considering indication for keratoplasty mean flare measurements were respectively in 1st, 3rd and 6th month for first group:
Fuchs’ dystrophy: 11,85 +/- 5,46 ph/ms; 8,28 +/- 1,80 ph/ms; 4,93 +/- 0,95 ph/ms; bullous
keratopathy: 17,08 +/- 1,89 ph/ms; 13,00 +/- 1,27 ph/ms; 7,03 +/- 3,32 ph/ms. In second group
respectively: keratoconus: 15,15 +/- 1,34 ph/ms; 11,95 +/- 0,49 ph/ms; 11,25 +/- 0,64 ph/ms;
corneal cicatrix without neovascularization: 16,40 +/- 9,27 ph/ms; 12,13 +/- 9,85 ph/ms; 6,87 +/-
4,20 ph/ms; endangering corneal perforation: 21,75 +/- 2,54 ph/ms; 18,78 +/- 3,21 ph/ms; 13,25 +/-
1,92 ph/ms. In the analysis of indications for keratoplasty the lowest mean aqueous flare in 1st, 3rd,
and 6th month after procedure was observed in the Fuchs’ dystrophy. In endangering corneal
perforation mean flare values were the highest.
Conclusions: Our results indirectly indicate that in examined patients after DSEK post-operative
inflammatory reaction is lower than in PK. Furthermore flare values might depend on the
indications for keratoplasty. The study was performed in group with various indications for
keraoplasty. Further studies including protein concentration in AH after DSEK and PK performed
in equal indications are needed.
