Descemet-Stripping Automated Endothelial Keratoplasty

Gorovoy, Mark S.

doi:10.1097/01.ico.0000214224.90743.01

Cited by 800 publications

(532 citation statements)

References 12 publications

Supporting

Mentioning

483

Contrasting

Unclassified

Order By: Relevance

“…Studies on DSEK/DSAEK generally report a better visual outcome than with PK, with visual acuities up to 20/40 (0.5) in a majority of cases, with only small percentages reaching 20/25 or better (X0.8). 10,11,19,23 Both in PK and DSEK/DSAEK, a final visual acuity is usually achieved at 6-12 months, whereas most DMEK patients reach their maximal visual potential at 1-3 months. 18 When comparing postoperative endothelial cell densities, a second major clinical outcome parameter in keratoplasty surgery, DMEK outcomes may be roughly similar to those after PK or DSEK/DSAEK.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] These techniques have been popularised in the United States as 'deep lamellar endothelial keratoplasty' (DLEK), 7,8 and (femtosecond) Descemet stripping (automated) endothelial keratoplasty (DSEK/DSAEK/FS-DSEK). [9][10][11][12] In 1998, we also described a technique for selective transplantation of Descemet membrane through a self-sealing 3.5 mm clear corneal incision, 13,14 tentatively named Descemet membrane endothelial keratoplasty (DMEK). [15][16][17][18] As PK has been the gold standard for keratoplasty for almost a century, 19 an alternative technique should bring major advantages in clinical outcome, reducing complications as well as technical feasibility, to get accepted and to change a longstanding consensus in ophthalmology.…”

Section: Introductionmentioning

confidence: 99%

“…The early forms of endothelial keratoplasty, that is, DLEK and DSEK/ DSAEK, may have shown that the visual outcome could compete with PK, whereas the most frequent long-term complications were minimised. [1][2][3][4][5][6][7][8][9][10][11] Endothelial keratoplasty shows little induced astigmatism because the recipient corneal surface is not compromised; suturerelated problems are eliminated as endothelial keratoplasty requires no (corneal) sutures; and wound healing-related complications are rare, because instead of a circular corneal wound, the procedure can be performed through a self-sealing limbal or scleral tunnel incision.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy: review of the first 50 consecutive cases

Ham

Dapena

Luijk

et al. 2009

Eye

213

142

View full text Add to dashboard Cite

Purpose: To evaluate the clinical outcome and complications of Descemet membrane endothelial keratoplasty (DMEK), using Descemet-stripping endothelial keratoplasty (DSEK) as a back-up procedure, in the management of Fuchs endothelial dystrophy. Design: Non-randomised prospective clinical study. Methods: The first fifty consecutive eyes that underwent DMEK, that is, transplantation of an isolated donor Descemet membrane carrying its endothelium, for Fuchs endothelial dystrophy were evaluated. In all eyes, the best-corrected visual acuity (BCVA) as well as the endothelial cell density (ECD) was measured before and at 6 months after surgery, as clinical outcome parameters. Results: Ten patients required a secondary DSEK for failed DMEK. In the remaining 40 DMEK eyes, 95% had a BCVA of X20/40 (X0.5) and 75% X20/25 (X0.8) at 6 months after surgery. ECD averaged 2618 ( ± 201) cells/mm 2 before, and 1876 ( ± 522) cells/mm 2 at 6 months after surgery (n ¼ 35). When the outcomes of DMEK and secondary DSEK procedures were combined, 94% reached a BCVA of X20/40 (X0.5) and 66% X20/25 (X0.8) (n ¼ 47), and ECD averaged 2623 ( ± 193) cells/mm 2 before, and 1815 ( ± 578) cells/mm 2 at 6 months after surgery (n ¼ 43). Conclusion: With DSEK as a back-up procedure, DMEK may provide relatively quick and complete visual rehabilitation in a majority of patients operated on for Fuchs endothelial dystrophy. Endothelial cell survival may be similar to earlier types of (lamellar) keratoplasty. Early graft detachment was the main complication in this first series of DMEK surgeries for Fuchs endothelial dystrophy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy: review of the first 50 consecutive cases

Ham

Dapena

Luijk

et al. 2009

Eye

213

142

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4][5][6][7][8][9][10] Both procedures are less invasive corneal transplant techniques. In comparison with penetrating keratoplasty main advantages include rapid healing, more predictable refractive outcomes, better corneal integrity, a rapid visual recovery, and fewer postoperative complications.…”

Section: Introductionmentioning

confidence: 99%

“…In comparison with penetrating keratoplasty main advantages include rapid healing, more predictable refractive outcomes, better corneal integrity, a rapid visual recovery, and fewer postoperative complications. 1,[4][5][6][7]11,12 DSAEK procedure was first described by Price and Price. 4,7 The diseased endothelium and Descemet membrane are selectively replaced by posterior corneal stroma, Descemet membrane, and endothelium of a donor.…”

Section: Introductionmentioning

confidence: 99%

Retrospective contralateral study comparing Descemet membrane endothelial keratoplasty with Descemet stripping automated endothelial keratoplasty

Maier

Gundlach

Gonnermann

et al. 2014

Eye

View full text Add to dashboard Cite

Purpose In this retrospective study, the visual outcomes and postoperative complications after Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) in the fellow eye were compared. The patient's satisfaction was evaluated. Methods A retrospective analysis of 10 patients, who underwent DSAEK in one eye and DMEK surgery in their fellow eye, was performed. Intraoperative and postoperative complications were recorded. Visual and refractive outcomes were evaluated, including higher-order aberrations (HOA) and contrast thresholds. A subjective questionnaire was used to evaluate patient satisfaction. Results Best-corrected visual acuity (BCVA) was significantly better in DMEK when compared with DSAEK (0.16 ± 0.10 vs 0.45 ± 0.58 logMAR, P ¼ 0.043). Contrast threshold was significantly higher after DMEK than after DSAEK (0.49 ± 0.23 vs 0.25±0.18, P ¼ 0.043). Post-keratoplasty astigmatism, mean spherical equivalent, and HOA did not differ. Nine out of ten patients preferred the DMEK procedure. Visual outcome (4.80 ± 1.14 vs 4.50 ± 1.58, P ¼ 0.257), surgery associated pain and burden (DMEK: 1.30 ± 0.48 vs DSAEK: 1.30 ± 0.48, P ¼ 1.0), estimated time for recovery and rehabilitation (27.6 ± 54.0 vs 24.9 ± 54.8 days, P ¼ 0.173), and mean patient satisfaction (5.40 ± 0.84 vs 5.00 ± 1.05, P ¼ 0.257) were evaluated equally. Conclusion Patient satisfaction reached high, equal values after DMEK and after DSAEK. Nevertheless, patients preferred DMEK, if given a choice. Reasons for the preference may include better uncorrected and BCVA, and especially a better contrast sensitivity.

show abstract

Preliminary Results of Femtosecond Laser–Assisted Descemet Stripping Endothelial Keratoplasty

Cheng

Hendrikse

Pels³

et al. 2008

Arch Ophthalmol

View full text Add to dashboard Cite

To evaluate the preliminary visual results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK). Methods: We prospectively analyzed results of 20 consecutive patients with Fuchs endothelial dystrophy or aphakic/pseudophakic bullous keratopathy who underwent FS-DSEK. Best spectacle-corrected visual acuity (BSCVA), refraction, corneal topography, and endothelial cell density were measured preoperatively and 3 and 6 months after FS-DSEK. Corneal thickness was measured using an optical coherence tomography technique. Results: The average BSCVA of 11 eyes with normal visual potential significantly improved from 20/110±4 lines to 20/57±1 line at 6 months (PϽ.007). At 6 months, the mean (SD) hyperopic shift was 2.24 (2.3) diopters (D). Preoperative and 6 months postoperative refractive astigma-tism were −0.75 (0.9) D and −1.58 (1.1) D (P=.01), but the topographic astigmatism did not change postoperatively (P=.95). Mean (SD) endothelial cell density at 6 months was 1368 (425) cells/mm 2. There was a persistent deswelling of the graft up to 3 months postoperatively. Complications included graft dislocations requiring repositioning (20%), pupillary block glaucoma (5%), epithelial ingrowth (5%), and primary graft failure (5%). Conclusions: Femtosecond laser-assisted Descemet stripping endothelial keratoplasty was effective in treating endothelial failure with minimal induced refractive astigmatism, limited improvement of BSCVA, and induction of a hyperopic shift. Endothelial cell count and dislocation rate were significant, which may be related to the surgical technique.

show abstract

Descemet-Stripping Automated Endothelial Keratoplasty

Abstract: DSAEK surgery allows rapid, excellent BSCVA visual recovery. The rate of visual recovery is more rapid than usually found with penetrating keratoplasty.

Cited by 800 publications

References 12 publications

Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy: review of the first 50 consecutive cases

Descemet membrane endothelial keratoplasty (DMEK) for Fuchs endothelial dystrophy: review of the first 50 consecutive cases

Retrospective contralateral study comparing Descemet membrane endothelial keratoplasty with Descemet stripping automated endothelial keratoplasty

Preliminary Results of Femtosecond Laser–Assisted Descemet Stripping Endothelial Keratoplasty

Contact Info

Product

Resources

About