Evaluation of aqueous flare after Descemet’s stripping endothelial keratoplasty and penetrating keratoplasty

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.