The short-term results of Descemet's stripping and automated endothelial keratoplasty

PURPOSE: To investigate the short-term results of Descemet's stripping and automated endothelial keratoplasty (DSAEK) for endothelial dysfunction. MATERIALS AND METHODS: Twenty-three eyes of 23 patients with corneal edema following DSAEK were retrospectively analyzed. Corneal edema following laser iridotomy was the most common cause (13 eyes) followed by pseudophakic bullous keratopathy (5 eyes). Donor buttons prepared by the oversea eye banks were used (pre-cut donor button). They were inserted through a 5-mm incision using either the taco technique (7 eyes) or pull-through technique (16 eyes). After surgery air was injected into the anterior chamber at the end of surgery. Ten patients underwent simultaneous phacoemulsification and posterior chamber intraocular lens implantation. Corneal clarity, visual acuity, astigmatism, and endothelial cell density were investigated. RESULTS: Mean decimal preoperative best-corrected visual acuity was 0.05. Postoperatively, 13/23 (56.5%) patients achieved visual acuity of 0.5 or better at last follow-up. Mean postoperative astigmatism was within 2 D. Mean endothelial cell density of donor corneas was 2567 +/- 294 cells/mm2, and the mean density was 957 +/- 314 cells/mm2 6 months after DSAEK. CONCLUSIONS: DSAEK provided excellent refractive and reasonable visual outcomes in this shortterm observation. Prevention of endothelial loss seems to be the key to long-term success.