<p>Different graft thicknesses after Descemet stripping endothelial keratoplasty for bullous keratopathy in the two eyes of the same patient</p>

Abstract

Objective To describe a very unique case of two Descemet stripping automated endothelial keratoplasty (DSAEK) surgeries performed in both eyes of the same patient with an extremely different graft thickness and overall corneal thickness but with the same corrected distance visual acuity (CDVA) 2 years after surgery. Case presentation A 75-year-old woman with bilateral bullous keratopathy (BK) was submitted to DSAEK surgeries in both eyes, first in right and after 6 months in left eye. CDVA was 20/160 in the right eye and 20/63 in the left eye. Corneal thickness evaluated by anterior segment optical coherence tomography was 569 µm in the right eye and 560 µm in the left eye. The root mean square (RMS) was 2.1 in the right and left eyes. Endothelial cell densities were not detectable in both eyes. The estimated precut donor graft thickness from eye bank was 250 and 40 µm in the right and in the left graft, respectively. Two years after surgery CDVA was 20/25 in both eyes. Corneal thickness was 633 µm with a lenticule thickness of 206 µm in the right eye and 439 µm with a lenticule thickness of 48 µm in the left eye. The RMS was 1.7 in the right eye and 1.4 in the left eye. Endothelial cell density was 2.272 cells/mm 2 in the right and 2.154 cells/mm 2 in the left eye. Conclusion DSAEK was safe and effective in the treatment of BK. In our report, the visual outcome resulted to be poorly related either to donor graft thickness or to postoperative corneal thickness.

Experimental Rationale for Using an Eximer Laser for Preparation of Ultrathin Graft for Posterior Lamellar Keratoplasty

“…Задняя послойная кератопластика (ЗПК) -относительно новая хирургическая техника, при которой пациентам с недостаточностью заднего эпителия роговицы различного генеза пересаживают донорский эндотелий. ЗПК имеет ряд преимуществ перед сквозной кератопластикой (СКП) [1].…”