Visual Outcome, Refractive Error and Specular Microscopy Parameters Following Successful DSAEK

Abstract

Background: Descemet stripping and automated endothelial keratoplasty (DSAEK) has gained widespread popularity in the treatment of corneal endothelial dysfunction. In the present study, we evaluated the outcome of DSAEK in our center. Methods: This retrospective cross-sectional study was conducted on 60 patients, who had undergone DSAEK at least 12 months before in Khalili Hospital, Shiraz University of Medical Sciences. On follow-up, best spectacle-corrected visual acuity (BSCVA), refractive errors and specular microscopy parameters were assessed. Results: The majority of the studied eyes (49.2%) had a BSCVA within the range of 20/40 to 20/30. BSCVA was worse than 20/200 in 8 (13.3%) patients; 6 (75%) patients showed graft failure and 2 (25%) patients had graft rejection. Mean post-operative astigmatism was 0.29 ± 1.88 diopters. The mean refractive hyperopic shift was 1.30 ± 1.34 diopters. Specular microscopy indicated that 3 (5.1%) patients had cell density of less than 700 cells/mm2, but in none of the patients cell density was less than 500 cells/mm2. Furthermore, hexagonality of endothelial cells in 50% of the eyes was 54% to 67%. Mean coefficient of variant was 27.76%. Abnormal variations in specular microscopy findings were mostly confined to endothelial cell density, sparing other parameters. Conclusions: In general, results of this study demonstrated acceptable BSCVA in the average duration of one-year post-DSAEK regarding late complications such as graft failure, graft rejection and epithelial downgrowth.