DSEK, PK yield similar graft survival, endothelial cell loss rates

Ophthalmology. 2011;118(4):725-729.

Five-year graft survival and endothelial cell loss rates after Descemet's stripping endothelial keratoplasty were similar to those following penetrating keratoplasty, a study found.

"These 5-year findings, combined with the well-documented short-term advantages of DSEK, support its use for treatment of endothelial dysfunction," the study authors said.

The retrospective, interventional case series included 165 eyes of 149 patients who underwent DSEK between December 2003 and March 2005. DSEK outcomes were compared with PK outcomes recorded in the multicenter Cornea Donor Study.

Median recipient age was 71 years; 147 eyes were treated for Fuchs' dystrophy and 18 eyes were treated for pseudophakic or aphakic corneal edema.

Primary graft failure occurred in one eye, which subsequently underwent PK. At 5 years, 118 eyes that were available for examination had clear DSEK grafts; secondary graft failure had occurred in 10 eyes.

DSEK graft survival rates at 5 years were 95% for Fuchs' dystrophy and 76% for pseudophakic or aphakic corneal edema; the difference was statistically significant (P = .0087). Previous glaucoma surgery correlated significantly with graft failure (P < .0001).

PK graft survival rates were 93% for Fuchs' dystrophy and 73% for pseudophakic or aphakic corneal edema.

Endothelial cell loss was 53% in DSEK eyes and 70% in PK eyes at 5 years.