Long-Term Outcome of Descemet-Stripping Automated Endothelial Keratoplasty in Eyes Wıth Endothelial Failure
Purpose
Descemet stripping automated endothelial keratoplasty (DSAEK) has become the preferred method of treating endothelial dysfunction compared with penetrating keratoplasty. DSAEK provides faster visual recovery with minimal refractive change, and essentially eliminates ocular surface complications and the risk of losing the eye to intraoperative suprachoroidal hemorrhage or postoperative trauma.1 The aim of the this study is to evaluate the long-term outcome of DSAEK in eyes with endothelial failure.
Methods
Forty-five eyes of 45 patients (26 male/19 female) who underwent DSAEK between march 2005 and january 2011 were included in this prospective, randomized study. •Eye-bank determined endothelial cell count (ECC) of more than 2500 cells/mm2 donor endothelial tissue were used. Graft clarity, intraoperative and postoperative complications were recorded.
Results
The mean age of the patients were 68.31 ± 6.11 (range, 59 to 77) years. •The mean follow-up was 4.5 ± 1.4 years (range 3 to 7 years). Of the 45 patients enrolled in the study, 18 were pseudophakic bullous keratopathy, 10 were endothealial rejection following penetrating keratoplasty, 12 were Fuch’s endothealial dystrophy and 5 were corneal endothealial rejection following toxic anterior segment syndrome. Of the 45 DSAEK subjects enrolled in the study, 28 (62%) were examined and found to have clear grafts at 3 years. •The 3-year graft survival rate was 92% for DSAEK in eyes treated for Fuchs’ dystrophy, and it was 83% with DSAEK in eyes treated for pseudophakic bullous keratopathy. In subjects treated for Fuchs’ dystrophy, the median 3-year cell loss was 46% with DSAEK.
Conclusion
The 4-year graft survival rate for DSAEK were 60% (23/40 cases).