The outcomes of Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) for corneal endothelial dysfunction

OBJECTIVE: Descemet’s Stripping Automated Endothelial Keratplasty (DSAEK) results in corneal endothelial dysfunction was reported in this paper.
METHODS: Twenty-five eyes of 25 patients having endothelial dysfunction were included in this study. Preoperatively and postoperatively complete ophthalmic examinations were performed including uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness (CCT), endothelial cell density (ECD) and complications were recorded.
RESULTS: 19 eyes (76%) had bullous keratopathy, 4 eyes (16%) had Fuch’s endothelial dystrophy and 2 eyes (8%) had corneal graft failure. The mean follow up period was 20.8±7.8 months (6-36 months). The mean UCVA was improved from 0.11±0.11 (range, hand motion-0.3) to 0.52±0.23 (range, 0.1-0.9) (p<0.05). At the last visit the mean BCVA was improved from 0.12±0.12 (range, hand motion-0.3) to 0.65±0.26 (range, 0.1-1.0) (p<0.05). In 20 (75%) eyes, the mean BCVA was 0.3 or better at the last control visit. The mean ECD of donor corneas were 2378.24±250.34 cell/mm² preoperatively. At the
first month the mean ECD was 1783.34±256.93 cell/mm² (range, 75-2017.43). At the last control visit the mean ECD was 1671.98±235.54 cell/mm² (1497.45-1954.34). The mean IOP was 15.12±2.24 mmHg (range, 11-21 mmHg) preoperatively. At the last control visit the mean IOP was 14.83±1.34 mmHg (range, 13-17 mmHg). CCT was
640.36±14.82 μ (range, 624-678 μ) at the first control and it was 639.54±15.76 μ (range, 621-679 μ) at the last control visit.
CONCLUSION: DSAEK surgery was found to be safe and effective in corneal endothelium diseases. This method is expected to be used more frequently in the future with advances in technique.

Korneal endotelyal disfonksiyonlu hastaların tedavisinde DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty) sonuçları

AMAÇ: Bu yazıda, endotel yetersizliği bulunan hastalarda DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty) ameliyatı sonuçları değerlendirildi.
YÖNTEMLER: DSAEK tekniği ile endotelyal keratoplasti yapılan 25 hastanın 25 gözü çalışmaya alındı. Ameliyat öncesi ve sonrası kontrollerde düzeltilmemiş görme keskinliği (DGK), düzeltilmiş en iyi görme keskinliği (DEGK), göz içi basıncı (GİB), merkezi kornea kalınlığı (MKK), endotel hücre yoğunluğu (EHY) ve komplikasyonlar kaydedildi.
BULGULAR: Ameliyat öncesi 19 (%76) gözde büllöz keratopati, 4 (%16) gözde Fuch distrofisi ve 2 (%8) gözde greft yetersizliği mevcut olup ortalama takip süresi 20.8±7.8 ay (6-36 ay) idi. DGK ameliyat öncesi 0.11±0.11 (el hareketi-0.3) iken, son kontrolde 0.52±0.23 (dağılım, 0.1-0.9) idi (p<0.05). DEGK ameliyat öncesi ortalama 0.12±0.12 (el hareketi-0.4), son kontrolde DEGK 0.65±0.26 (dağılım, 0.1-1.0) idi (p<0.05). Son kontrolde 20 (%75)
gözde DEGK görme keskinliği 0.3 ve daha iyiydi. Ameliyat öncesinde donör kornealarda ortalama EHY 2378.24±250.34 hücre/mm² idi. Birinci ay kontrollerde EHY 783.34±256.93 hücre/mm² (dağılım, 75-2017.43), son kontrolde 1671.98±235.54 hücre/mm² (dağılım, 1497.45-1954.34) idi. Ameliyat öncesi ortalama GİB 15.12±2.24 mmHg (dağılım, 11-21 mmHg), son kontrolde 14.83±1.34 mmHg (dağılım, 13-17 mmHg) idi. Ameliyat sonrası ilk kontrolde MKK 640.36±14.82 μ (dağılım, 624-678 μ) ve son kontrolde 639.54±15.76 μ (dağılım, 621-679 μ) idi.
SONUÇ: Korneal endotel patolojilerinde DSAEK cerrahisi etkili ve güvenilir bir yöntem olup teknikteki ilerlemelerle beraber sıklıkla uygulanabileceği tahmin edilmektedir.