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Istopathological aspects of complications of DSAEK: our experience
Author(s) -
PESCE G,
VALENZANO E,
MACINAGROSSA G,
DI GESU I,
MONTRONE F
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.1755-3768.2009.328.x
Subject(s) - medicine , bullous keratopathy , cornea , corneal transplantation , surgery , complication , dystrophy , perioperative , ophthalmology , stroma , graft rejection , descemet membrane , transplantation , pathology , immunohistochemistry
Purpose Descemet–stripping automated endotelium Keratoplasty (DSAEK) is a selective tissue transplanation procedure in which only the deseaded endotelium and descemet membrane is replaced. The aim is to study the histopathologic features of DSAEK graft removed after graft failure and to correlate with relevant clinical features. Methods Retrospective study of 2 cases of DSAEK graft failure in 22 patients who underwent DSAEK for Fuchs Endotelial Dystrophy and Bullous keratopathy. Perioperative clinical finding were correlated with pathologic finding of the explanted graft specimens. Anormalities in the DSAEK graft and in the interface between the recipient cornea and the DSAEK graft were studied. Results All DSAEK procedures were uneventful. All graft failure occured in association with graft dethacment or more surgical manipolation. In 1 case the donor tessue detached in CA, in 1 cases the graft remained attached but failed to clear. By ligthmicroscopy, explanted donor tessue showed the presence of extentively damaged keratocytes in the deep posterior stroma and also in the interface at the graft‐ host junction. Histopatologic evaluation showed marked corneal edema and endotelial cell loss. Conclusion The DSAEK proves to be a viable surgical technique in cases of imbalance corneal from endothelial problems. Rare are the cases of failure, in which histopathological study shows that the complication is due to bullous detachment between the two flaps, because of failure histopathological and clinical surgery