Comparison of long-term clinical outcomes between descemet's stripping endothelial keratoplasty and deep lamellar endothelial keratoplasty

Abstract

To investigate the differences of long-term clinical outcomes between two kinds of corneal endothelial keratoplasty (EK): DSEK and DLEK. Retrospective, comparative, clinical case series study. Twenty-six patients (26 eyes), undergoing DLEK and thirty-six patients (36 eyes), undergoing DSEK during the period of October 2005 to March 2008, were involved in this study. Before and at 6 month intervals after surgery, patients' data were collected to analyze the surgery success rate, graft dislocation rate, best corrected visual acuity (BSCVA), graft survival rate and endothelial cell density (ECD). The follow-up time was 3 to 5 years. The success rate of DLEK was 88.5% while DSEK was 86.1%. Average BSCVA of DLEK were similar to those of DSEK at each follow-up time after 12 months postoperatively. Graft survival rates of DLEK and DSEK were respectively 87% and 75.9%, where as ECD were respectively 1638 cells/mm(2) and 1874 cells/mm(2) at 36 month postoperatively, the data were similar in both ECD and graft survival rate between DLEK and DSEK at 60 months postoperatively. The success rate and long-term visual outcomes of DLEK were similar with those of DSEK. To obtain objective results, it is better to consider both ECD and graft survival rate instead of recording ECD only for its localization in evaluating the efficacy of EK.