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    Finding alternative techniques for eyes with failed PK

    Cornea surgeons encountering a patient with failed penetrating keratoplasty (PK) will wonder if they should repeat the PK.

    Although there are some exceptions to the rule, according to Donald T.H. Tan, MD, the answer is “no.”

    Speaking at Cornea 2017, Dr. Tan provided an overview of studies evaluating outcomes of different techniques for managing eyes with a failed PK.

    “As the learning curve for Descemet-stripping automated endothelial keratoplasty (DSAEK) and now Descemet membrane EK (DMEK) allows us to reduce complications and rejection rates of repeat grafting, it is likely that less repeat PKs will be performed,” Dr. Tan, professor of ophthalmology, National University of Singapore, Singapore.

    “As we get better at EK, there is the potential for less rejection and enhanced long-term graft survival [with the EK procedures],” Dr. Tan said.

    “In addition, the Boston Type 1 Keratoprosthesis (Boston KPro) now appears to be a truly viable alternative to repeat PKs, providing improved intermediate-term survival rates,” he said. “However, we need further follow-up to determine the long-term success rates of the Boston Kpro as compared to EK surgery.”

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