Descemet Stripping and Automated Endothelial Keratoplasty: An Alternative to Penetrating Keratoplasty

Chih, Andreea; Lugo, Miguel; Kowing, Dianne

doi:10.1097/opx.0b013e3181646d2f

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…134 New surgical methods, which may replace some penetrating keratoplasty procedures, involve replacement of only the posterior cornea in those patients in whom corneal decompensation is due to endothelial dysfunction. The cornea is normally devoid of antigen processing because of the lack of blood vessels and so the rate of graft rejection is usually quite low.…”

Section: Clinical Comment: Keratoplastymentioning

confidence: 99%

Cornea and Sclera

Remington

2012

Clinical Anatomy and Physiology of the Visual System

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Section: Clinical Comment: Keratoplastymentioning

confidence: 99%

Cornea and Sclera

Remington

2012

Clinical Anatomy and Physiology of the Visual System

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“…The conventional surgical treatment strategies include Descemet membrane endothelial keratoplasty, Descemet stripping (automated) endothelial keratoplasty, pre-Descemet´s endothelial keratoplasty, femtosecond laser-assisted keratoplasty, or penetrating keratoplasty to repair the missing Descemet membrane. [1][2][3] To avoid complications of long-term immunosuppressive treatment after keratoplasty, new salvage agents are the subject of intense research. 4 In our case report, we have documented a previously undescribed mechanism of descemetorhexis during anterior capsulotomy creation.…”

Section: Introductionmentioning

confidence: 99%

A Case Report Illustrating the Spontaneous Vision Recovery After Inadvertent Central Descemetorhexis During Anterior Capsulotomy

Baráková¹,

Darsova²

2021

IMCRJ

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Purpose To demonstrate an unusual mechanism of iatrogenic, central descemetorhexis (DMR) during cataract surgery and subsequent rare spontaneous visual acuity improvement within 2 months after inadvertent surgical complication. Patients and Methods A 81 year old woman underwent cataract surgery complicated by the loss of a 4.8X4.75 mm diameter central area of Descemet membrane. Perioperative video recording documented the DMR formation during continuous curvilinear capsulorhexis creation. Results Postoperatively, severe corneal edema with folds in the remaining Descemet membrane were observed. The patient was managed conservatively. The corneal edema gradually resolved over 2 months with improving of visual acuity from counting fingers to 20/20. Conclusion Unlike Descemet membrane detachment, descemetorhexis is a rare complication after intraocular surgery. The case report identifies a previously unknown mechanism of DMR formation during anterior capsulotomy creation. Loss of Descemet membrane may be managed conservatively in an otherwise healthy cornea with good final visual outcome without the need for surgical intervention.

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“…The main indication for DSAEK is endothelial dysfunction, as found in Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. [1–3] It has advantages of faster visual recovery and better visual quality secondary to less induced irregular astigmatism. Furthermore, the globe become tectonically stronger, no suture-related surface problems, better neurotrophic status, and less graft rejection or infection.…”

Section: Introductionmentioning

confidence: 99%

Initial experience with Descemet stripping automated endothelial keratoplasty in Saudi Arabia

Hantera¹,

Sayyed²,

Arfaj³

2012

Oman J Ophthalmol

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Purpose:To analyze the visual results of Descemet stripping automated endothelial keratoplasty (DSAEK) in the first consecutive 10 cases.Materials and Methods:Retrospective, non-randomized, non-comparative interventional case series. Ten eyes of 10 patients with endothelial dysfunctions of different etiology, scheduled for DSEAK, were included in this study. Indications, operative problems, and postoperative complications were noted. Best-corrected visual acuity, refractive and keratometric astigmatism, and central corneal thickness were analyzed for each patient after a minimum follow-up of 10 months.Results:In a median follow-up of 12 months (range 10–16 months), visual outcomes were satisfactory. Preoperative diagnosis included five eyes of psuedophakic bullous keratopathy and two eyes of repeated failed corneal grafts and one bullous keratopathy secondary to anterior chamber phakic IOL implantation. Two eyes with Fuchs dystrophy and cataract had combined DSAEK and phacoemulsification and IOL implantation. One patient had known glaucomatous optic nerve precluding vision better than 20/150. Of the remaining nine patients, four eyes had BSCVA of 20/40 or better by postoperative 6 months (3 by 3 months). The average pachymetry was 646.9 μm. One patient had total graft dislocation and one needed trabeculectomy. None of the patients developed graft rejection or graft failure. None of patients needed to convert to penetrating keratoplasty.Conclusion:DSAEK is safe and effective procedure in patients with endothelial dysfunctions with encouraging surgical and visual outcomes.

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Descemet Stripping and Automated Endothelial Keratoplasty: An Alternative to Penetrating Keratoplasty

Cited by 6 publications

References 20 publications

Cornea and Sclera

Cornea and Sclera

A Case Report Illustrating the Spontaneous Vision Recovery After Inadvertent Central Descemetorhexis During Anterior Capsulotomy

Initial experience with Descemet stripping automated endothelial keratoplasty in Saudi Arabia

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