Introduction. Sutureless transplantation of endothelium on a thin stromal
carrier was introduced under the name of Descemet stripping endothelial
keratoplasty (DSEK) in 2004. It has become the treatment of choice of corneal
oedema due to endothelial dysfunction. Objective. To investigate posterior
lamellar graft attachment, central corneal thickness (CCT), astigmatism, and
best corrected visual acuity (BCVA) during one-year follow-up. Methods.
Surgery was performed on one eye of 11 patients with pseudophakic bullous
keratopathy and Fuchs? dystrophy. The graft thick 150-200 ?m and 8.0 mm in
diameter was detached manually. The carrier of the recipient cornea was
created by DSEK. The graft was folded in half, introduced into the anterior
orbital chamber through a 5.0 mm cut on the limbus and attached by air bubble
along the internal side of the recipient cornea. CCT and astigmatism were
evaluated by corneal topography, and graft attachment by biomicroscopy.
Results. One year after surgery, all grafts remained attached. Primary graft
failure occurred in three eyes, probably due to the crushing effect of the
forceps. BCVA was 20/30 (2 eyes), and 20/40 (6 eyes), CCT 643-728 ?m, and
astigmatism 1.1 D to 2.9 D. The peak values were reached three months after
surgery, and did not change much afterwards. Conclusion. This is the first
report on the long-term results of DSEK in our literature. The results are
similar to those obtained by more experienced DSEK surgeons, and suggest that
this procedure is safe and successful.
Descemet Stripping Endothelial Keratoplasty in Microcornea for Pseudophakic Bullous Keratopathy With Anterior Chamber Intraocular Lens
