April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
Descemets Stripping Endothelial Keratoplasty (DSEK) in Eyes With Failed Penetrating Keratoplasty
Author Affiliations & Notes
  • H. Ailani
    Ophthalmology, Wills Eye, Philadelphia, Pennsylvania
  • J. Zahler
    Ophthalmology, Phildelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
  • I. Raber
    Ophthalmology, Wills Eye, Philadelphia, Pennsylvania
  • B. Ayres
    Ophthalmology, Wills Eye, Philadelphia, Pennsylvania
  • K. M. Hammersmith
    Ophthalmology, Wills Eye, Philadelphia, Pennsylvania
  • Footnotes
    Commercial Relationships  H. Ailani, None; J. Zahler, None; I. Raber, None; B. Ayres, None; K.M. Hammersmith, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 2208. doi:
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    • Get Citation

      H. Ailani, J. Zahler, I. Raber, B. Ayres, K. M. Hammersmith; Descemets Stripping Endothelial Keratoplasty (DSEK) in Eyes With Failed Penetrating Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2208.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To report the results of patients undergoing Descemets Stripping Endothelial Keratoplasty (DSEK) in eyes with failed penetrating keratoplasty (PK).

Methods: : A retrospective review of 20 patients who underwent DSEK for graft failure after 1 or more PK’s from 2006-2008 by surgeons on the Wills Cornea Service. Data collected included initial indication for graft, reason for failure, pre and post op best corrected visual acuity, graft size, post operative complications (ex. graft dislocation, failure or rejection).

Results: : Three hundred cases of DSEK were reviewed. Twenty cases of DSEK in patients with history of previous PK were identified. DSEK was successfully performed in 19/20 cases. Eighteen showed improvement of best corrected visual acuity (mean pre op BCVA 20/400 vs mean post op BCVA of 20/80) with a mean follow up of 6.2 months. There were a total six graft dislocations (30%) in the early post op period. Three out of six of these cases were successfully reattached at the slit lamp on post op day 1. Two cases were taken back to the operating room for graft reattachment and one case underwent repeat PK. There were no cases of primary iatrogenic graft failure or graft rejection and all grafts remained clear at last follow up. One case developed early post operative endophthalmitis with retinal damage. Ten cases were performed on eyes with prior glaucoma or retinal surgery. Follow up ranged from 1 week to 16 months.

Conclusions: : This series shows favorable visual outcomes for patients undergoing DSEK in eyeswith previous graft failure. In addition, DSEK can be performed successfully in eyes with otherocular surgeries.

Keywords: cornea: clinical science • cornea: endothelium 
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