DSAEK garnered improved results in eyes with failed PK, study shows

Descemet stripping automated endothelial keratoplasty can garner good visual outcomes and graft clarity in eyes with failed penetrating keratoplasty, a study suggests.

In a prospective case series, Douglas J. Covert, MD, MPH, and colleague Steven B. Koenig, MD, of the Eye Institute at the Medical College of Wisconsin, evaluated the efficacy of the procedure in seven eyes of seven consecutive patients with one or more failed grafts. Follow-up averaged 13 months.

One eye experienced repeat donor graft dislocation after the initial Descemet stripping automated endothelial keratoplasty (DSAEK), and the patient opted for repeat PK rather than repeat DSAEK, according to the study.

The results for the remaining six patients showed that vision improved from a mean preoperative visual acuity of 20/851 to a mean postoperative best corrected visual acuity of 20/65 (P = .008).

All eyes showed visual improvement, and four of the six eyes reached a BCVA of 20/40 or better, according to the study. In addition, all grafts remained clear at the final follow-up.

Two eyes showed graft dislocation requiring repositioning on the first postop day. In addition, two eyes underwent repeat DSAEK after being diagnosed with primary iatrogenic graft failure within 1 week of DSAEK, and one eye experienced acute graft rejection requiring topical steroids, according to the study.

"The complications observed were similar to those observed for DSAEK for Fuchs' dystrophy and pseudophakic bullous keratopathy," the authors said.

The study is published in the July issue of Cornea.