Endothelial keratoplasty without Descemet's stripping in congenital hereditary endothelial dystrophy

Abstract

To compare outcomes of non-Descemet's stripping endothelial keratoplasty (nDSEK) with Descemet's stripping endothelial keratoplasty (DSEK) for the surgical management of congenital hereditary endothelial dystrophy (CHED). Patients with CHED who were treated with DSEK or nDSEK were analyzed and compared with respect to graft adhesion, graft clarity, visual acuity, refraction, and complications. A total of 6 patients were included in the series. Of these, 3 (mean age, 5.6±1.52 years; 1 male) underwent DSEK and 3 (mean age, 5.6±0.57 years; 2 males) nDSEK. Preoperative best-corrected visual acuity of patients who underwent DSEK was 1.3 logMAR units compared with 1.13 logMAR units for nDSEK patients. There were no intraoperative complications. During the early postoperative period, 1 patient who had n DSEK had lenticule detachment and was successfully managed by repeat air injection. The average time for resolution of graft edema was 30 days. The postoperative best-corrected visual acuity was 0.13±0 .10 in DSEK patients and 0.13±0 .10 in nDSEK patients (P=1). Mean refraction was comparable in both groups of patients. The outcomes of nDSEK were similar to DSEK in CHED in this small series. The specific advantage of nDSEK is the decreased surgical time and intraocular tissue manipulation.