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Surgeon: DSEK has quick recovery, low astigmatism in endothelial dysfunction patients
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Descemet's stripping with endothelial keratoplasty can provide rapid visual recovery and minimal astigmatism in patients with endothelial dysfunctions, according to a prospective study.
In addition, the procedure can be successfully combined with manual small-incision cataract surgery with posterior chamber IOL implantation in patients with moderate to severe Fuchs' dystrophy with cataract, the author noted.
"This technique maintains the structural integrity of the globe with preservation of excellent ocular surface," Samar K. Basak MD, DNB, of Disha Eye Hospitals and Research Centre in West Bengal, India, said.
Dr. Basak evaluated visual and anatomic results after performing Descemet's stripping with endothelial keratoplasty (DSEK) on 75 eyes of 75 patients with various endothelial dysfunctions. Specifically, 18 of these eyes were phakic and 57 eyes were pseudophakic; all eyes had clinically significant stromal edema, microcystic epithelial edema or frank bullous keratopathy. All eyes received a healthy donor cornea with a cell count above 2,000 cells/mm².
Dr. Basak performed combined DSEK and manual small-incision cataract surgery with posterior chamber IOL implantation on 17 patients (22.7%) with moderate to severe Fuch's dystrophy with varying grades of cataract; one young patient had posterior polymorphous dystrophy and was treated with DSEK alone.
At 3 months, 62 eyes (82.7%) had achieved a best corrected visual acuity of 20/60 or better, the authors noted.
Mean refractive and keratometric astigmatism were 1.10 D of cylinder and 1.24 D of cylinder, respectively.
The central corneal thickness and endothelial cell density were 670.8 µm and 1,485.6 mm², respectively, according to the study.
Also at 3 months, endothelial cell loss averaged 26.8% (P < .05).
Dislocation of donor lenticule occurred in six eyes (8%) in the first 72 hours after surgery; one patient developed graft failure after 3 months due to intractable secondary glaucoma, according to the study, published in the July-August issue of Indian Journal of Ophthalmology.