Long-Term Functional and Anatomical Outcome after Descemet Stripping Automated Endothelial Keratoplasty: A Prospective Single-Center Study

Abstract EN

Purpose.

To investigate the long-term anatomical and functional outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods.

Prospective follow-up of 114 eyes (95 subjects) after DSAEK for endothelial dysfunction.

Measurements included best spectacle-corrected visual acuity (BSCVA), straylight, endothelial cell density (ECD), and graft thickness.

Results.

The mean follow-up time was 5.1 ± 1.5 years.

Four grafts ultimately failed (after 5 to 7 years).

From baseline up to 1 year after DSAEK, mean BSCVA improved by 0.30 logMAR.

This beneficial effect remained until the last follow-up (LFU).

After DSAEK, straylight was reduced.

ECD sharply dropped by 900 cells/mm2 (33%) immediately after surgery and, thereafter, steadily decreased at a rate of 11 cells/mm2 per month.

No significant correlation was observed between graft thickness at 3 years and BSCVA.

Conclusions.

We observed a low graft failure rate and a normalization of graft thickness.

Postoperative straylight remained elevated relative to the normal population.

The sharp initial and the subsequent more gradual ECD decline are consistent with other studies.

A significant and prolonged functional gain can be achieved by posterior lamellar grafting for endothelial dysfunction.