Outcomes of pre-cut DSAEK for endothelial failure at Moorfields Eye Hospital 2013-2014

Abstract

Purpose: Since June 2013, The Moorfields Lions Eye Bank has supplied pre-cut donor material for Descemet Stripping Automated Endothelial Keratoplasty (DSAEK). This study reviews the clinical outcomes of patients who have undergone DSAEK with pre-cut tissue at Moorfields Eye Hospital (MEH), London.

Methods: All patients who underwent pre-cut DSAEKs from June 2013 were included in this study. Clinical records were retrospectively reviewed and data was collected on surgical indication, graft detachment and survival.

Results: Data was collected for 32 eyes of 27 patients, with a mean age of 72 years. Twenty seven eyes had no comorbidity, three had advanced glaucoma and two were amblyopic. Two eyes had undergone previous glaucoma surgery.<br /> <br /> Surgical indications were: Fuchs’ endothelial dystrophy (24), pseudophakic bullous keratopathy (2), decompensated cornea (2), failed DMEK (2) and failed PK (2). Surgery was performed by nineteen surgeons; comprising four consultants and fifteen fellows. Five (16%) grafts detached within a week and were successfully repositioned. Three partial detachments spontaneously resolved. One DSAEK showed signs of primary graft failure at the three month post-operative stage. No graft rejection episodes were reported.

Conclusions: Pre-cut DSAEK outcomes in a teaching hospital environment are comparable to published series. Further standardisation in DSAEK surgical techniques could enhance consistency of clinical outcomes