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E. Pedrotti, A. Sbabo, P. Musetti, M. Passilongo, G. Marchini; Descemet Stripping Endothelial Keratoplasty (Dsek) With Artificial Anterior Chamber and Manual Dissection of the Donor Cornea: Preliminary Results. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2329.
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To evaluate safety and efficacy of Descemet stripping endothelial keratoplasty (DSEK) realized with artificial anterior chamber and manual dissection of the donor cornea in our first patient series.
DSEK was performed in 17 eyes of 17 patients (10 Fuchs dystrophies, 4 pseudophakic bullous keratopaties, 1 late graft failure, 1 corneal decompensation in a case of congenital plurioperated glaucoma, 1 corneal decompensation and cataract in a case of forceps trauma). Complete ophthalmic examination, UCVA (uncorrected visual acuity), BCVA (best corrected visual acuity) with manifest refraction, endothelial cells counting and the presence/absence of pain were evaluated preoperatively and after 1, 3 and 6 months from the surgery. The donor cornea was positioned on an artificial anterior chamber and manually dissected with Marchini-Pedrotti technique. Mean follow up was 7,1 ± 4,9 months.
In our first series of 17 eyes the following complications were registered: 2 primary graft failures, 1 pupillary block, 1 Urrets Zavalia syndrome, 1 case of ocular hypertension. At the 6th postoperative month mean BCVA was 0,53 ± 0,39 with a mean spherical equivalent of 0,52 ± 0,50. Mean BCVA of uncomplicated cases (12 eyes) was 0,69 ± 0,28. All patients experiencing pain in the preoperative period (65 %) were pain free from the first month after surgery.
Manual dissection of the donor cornea in DSEK provided functional posterior lamellas for the safe restoration of corneal integrity and endothelial function in corneal endothelial failure. Complications were easy to manage in the majority of cases.
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