Abstract
Purpose::
To evaluate the status of the corneal endothelium after Descemet Stripping Endothelial Keratoplasty (DSEK)
Methods::
Between October 2005 and September 2006, 45 patients underwent Descemet Stripping Endothelial Keratoplasty (DSEK) for the indications of: 1) Fuchs' dystrophy, 2) corneal edema, 3) pseudophakic bullous keratopathy, and 4) graft failure. Mean follow-up was one day to eleven months (mean 3.6 months). Endothelial cell counts were obtained starting at 3 months using confocal-derived speculum microscopy.
Results::
Clinical corneal clarity was achieved 6 to 8 weeks after surgery in 43 of 45 eyes (96%). There were 6 DSEK button dislocations, 5 were rebubbled successfully, and 2 required regrafting. Cell counts were available on 16 eyes one to ten months after surgery (mean 5.5 months). Donor endothelial cell counts ranged from 2860 cells/mmѲ to 3920 cells/mmѲ (mean 3260 cells/mmѲ ). Postoperative endothelial cell counts ranged from 810 to 2690 cells/mmѲ (mean 1520 cells mmѲ ).
Conclusions::
Descemet Stripping Endothelial Keratoplasty (DSEK) is a very effective method for visual rehabilitation of eyes with corneal endothelial disease. Graft clarity is achieved rapidly in the majority of cases. Causes of endothelial cell loss include intraoperative manipulation as well as postoperative attrition.
Keywords: cornea: endothelium • transplantation • cornea: clinical science