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DSAEK grafted corneas remain clear with low endothelial cell counts
Author(s) -
OLESEN H
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.2276.x
Subject(s) - medicine , ophthalmology , visual acuity , cornea , endothelial stem cell , corneal transplantation , surgery , eye bank , transplantation , biology , biochemistry , in vitro
Abstract Purpose Presentation of observations on endothelial viability and visual outcome in 30 consecutive eyes operated with Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) Methods DSAEK for Fuchs' dystrophy was introduced in October 2006 at the Eye Dept. at Rigshospitalet. The first 7 eyes were grafted with pre‐cut donor tissue, the remaining operations involved tissue preparation with a Moria keratome. All patients were monitored at regular post‐operative intervals for an average of 20 months (range 7 ‐ 34 months). Donor tissue condition was evaluated in terms of detachment rate, primary graft failure and rejection events. Endothelial cell counts (ECC) were done with a digital Topcon SP‐3000P specular microscope camera. Final visual outcome was recorded. Results A fairly large loss of endothelial cells during transplantation was noted. Average cell density of the donor buttons was 2400/mm². At one year follow‐up the recorded ECC had declined to 1129/mm² on average. At two years the average cell density was 1083/mm² indicating a slow progressive cell loss. At the latest follow‐up cell counts ranged from 429 to 2332/mm². Nonetheless all corneas were clear except for one, which was developing secondary bullous keratopathy. Patient satisfaction and visual performance and comfort did not seem correlated to the ECC. Median acuity was 20/40. No case of classical rejection was seen. Conclusion DSAEK is a tempting alternative to PKP in Fuchs' dystrophy. The learning curve, however, is steep even for experienced surgeons at the cost of endothelial cells during the tissue handling. Corneal clarity as well as visual funtion is retained even with very low cell densities.