Experienced surgeons, inexperienced fellows have similar good results with DSAEK

Am J Ophthalmol. 2009;148(1):26-31.

Descemet's stripping automated endothelial keratoplasty can be performed by both experienced and inexperienced surgeons with no difference in vision or endothelial cell loss after the procedure, a study found.

"Results and complications of DSAEK performed by supervised novice fellows can equal those of an experienced DSAEK surgeon," the study authors said.

The retrospective study analyzed 327 consecutive DSAEK cases performed by an experienced corneal surgeon and inexperienced fellows. Of those cases, 235 were performed by the attending corneal surgeon, while 92 were performed by the corneal fellows.

The study compared 6-month results of postoperative vision, immediate postop complications and endothelial cell loss. The surgeon and fellows used an identical technique to perform the surgeries.

Best corrected visual acuity improved from 20/80 to 20/37 in the attending cases and from 20/74 to 20/36 in the fellow cases. Endothelial cell loss also had no statistical difference between the attending and fellow cases.

In the attending cases, the dislocation rate was 2%, and in the fellow group, the rate was smaller, at 1%. No cases had primary graft failures or pupillary block.