Initial experience with Descemet stripping automated endothelial keratoplasty in Saudi Arabia

Abstract

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.

Outcome of descemet stripping automated endothelial keratoplasty in failed penetrating keratoplasty

“…A study from Saudi Arabia evaluating 10 cases of DSAEK as the primary surgery to manage corneal pathologies such as Fuchs endothelial keratopathy and bullous keratopathy, reported visual outcomes of 20/20–20/50. [ 13 ]…”

Surrogate scleral rim with fibrin glue: a novel technique to expand the pool of donor tissues for Descemet stripping automated endothelial keratoplasty

“…An adequate scleral rim2 (>3.6 mm) on all sides is mandatory for corneal scleral tissue to be mounted on the artificial anterior chamber (AAC) for microkeratome-assisted dissection. A tighter seal decreases the chances of tissue collapse during the movement of microkeratome 3. Due to unavailability of enough well-trained technicians in a developing country setup who are familiar with in-situ excision technique, there is a high probability of obtaining inadequate scleral rim (<3.6 mm) in donor tissues.…”