Clinical evaluation of non-Descemet stripping automated endothelial keratoplasty (nDSAEK)

Abstract

Purpose: To report the clinical outcomes of non-Descemet stripping automated endothelial keratoplasty (nDSAEK) as a treatment for endothelial dysfunction.

Methods: Nineteen eyes of 19 patients (mean age 74.2 years) with non-Fuchs-type bullous keratopathy suitable for endothelial keratoplasty were enrolled in this study. All participants underwent endothelial keratoplasty without Descemet stripping. Best corrected visual acuity (BCVA) and donor central endothelial cell density (ECD) were recorded preoperatively and postoperatively.

Results: All 19 cases had a clear graft at 1 year postoperatively. Mean BCVA improved from 0.80 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.20 logMAR after 3 months, 0.13 logMAR after 6 months, and 0.08 logMAR after 1 year. The average and standard deviations of ECD (cells/mm(2)) after 3 months were 2324 ± 493 (representing a 20.0% mean cell loss from preoperative donor cell measurements), 2268 ± 525 (22.0% decrease) after 6 months, and 2064 ± 665 (29.0% decrease) after 1 year. No intraoperative complications were noted. One case of transient pupillary air block was observed postoperatively.

Conclusions: This modified endothelial keratoplasty technique for the treatment of non-Fuchs-type endothelial dysfunction produced excellent clinical outcomes such as reduced endothelial cell loss and good visual acuity.