DSEK offers advantages over penetrating keratoplasty

Descemet’s stripping with endothelial keratoplasty provides “significant advantages” over penetrating keratoplasty, among them quicker healing rates, more predictable outcomes and better corneal strength retention, according to a study.

Francis W. Price Jr., MD, and Marianne O. Price, PhD, retrospectively analyzed data from the first 200 consecutive patients who underwent Descemet’s stripping with endothelial keratoplasty (DSEK). Follow-up ranged from 7 to 20 months in 124 eyes, and between 2 and 6 months in 76 eyes. The DSEK technique consisted of stripping Descemet’s membrane and endothelium from the recipient’s central cornea and transplanting an 8- to 9-mm disc of donor endothelium and posterior stroma through a 5-mm incision. Sutures were used only to close the incision, Drs. Price said.

There were seven primary graft failures, with only one occurring in the second 100 cases (those that primarily used microkeratome-dissected donor tissue). Other complications were infrequent, but included one case of papillary block glaucoma, one of aqueous misdirection syndrome and cataract development in two of 27 phakic eyes.

“Although donor adherence was more challenging, DSEK was technically easier and should be less traumatic to anterior chamber structures than earlier posterior grafting techniques,” the researchers said.

The study is published in the Journal of Cataract & Refractive Surgery.