Artículos de revistas: "DSAEK"

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Bhandari, Vipul, Jagdeesh K. Reddy, Kirti Relekar, and Vijayalakshmi Prabhu. "Descemet’s Stripping Automated Endothelial Keratoplasty versus Descemet’s Membrane Endothelial Keratoplasty in the Fellow Eye for Fuchs Endothelial Dystrophy: A Retrospective Study." BioMed Research International 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/750567.

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Aim. To evaluate visual outcome and endothelial cell density (ECD) after Descemet’s Membrane Endothelial Keratoplasty (DMEK) in comparison with Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) in the fellow eye for Fuchs endothelial dystrophy (FED).Design. Single-centre, retrospective case series.Methods. 30 eyes of 30 patients undergoing DMEK, who completed a 1-year follow-up, were compared with 30 fellow eyes which underwent DSAEK for bilateral FED. Main outcome measures studied included Best Corrected Visual Acuity (BCVA) and ECD during a 1-year follow-up period.Results. BCVA improved from 0.78 ± 0.35 logMAR, and 0.73 ± 0.31 logMAR before surgery to 0.22 ± 0.1 logMAR and 0.35 ± 0.12 logMAR 6 months after DMEK and DSEK, respectively (P<0.001). At one year after surgery, the BCVA was maintained at 0.21 ± 0.12 logMAR and 0.34 ± 0.1 logMAR, respectively, after DMEK and DSAEK. A statistically better visual outcome was observed after DMEK compared to DSAEK (P<0.05) in fellow eyes.Conclusions. DMEK provided better visual rehabilitation when compared to DSAEK. Nevertheless, there were no significant differences with regard to the ECD within a 1-year follow-up.

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John, Thomas. "Diferencia entre DSEK, DSAEK & DMEK." Highlights of Ophthalmology 43, no. 5ESP (2015): 9–11. http://dx.doi.org/10.5005/hos-10101-43503.

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John, Thomas. "Difference Among DSEK, DSAEK & DMEK." Highlights of Ophthalmology 43, no. 5ENG (2015): 9–11. http://dx.doi.org/10.5005/hoo-10101-43503.

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4

Wisse, Robert P. L., Jens A. Achterberg, and Allegonda Van der Lelij. "DSAEK." Cornea 33, no. 3 (2014): 230–34. http://dx.doi.org/10.1097/ico.0000000000000042.

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Droutsas, Konstantinos, Myrsini Petrelli, Dimitrios Miltsakakis, et al. "Visual Outcomes of Ultrathin-Descemet Stripping Endothelial Keratoplasty versus Descemet Stripping Endothelial Keratoplasty." Journal of Ophthalmology 2018 (November 1, 2018): 1–5. http://dx.doi.org/10.1155/2018/5924058.

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Purpose. To examine the impact of graft thickness (GT) on postoperative visual acuity and endothelial cell density after ultrathin-Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus conventional DSAEK. Methods. The medical records of all patients who underwent DSAEK at our institute during a 2-year period were reviewed. After excluding subjects with low visual potential, 34 eyes were divided into two groups based on the postoperative GT as measured with anterior segment optical coherence tomography (AS-OCT): an UT-DSAEK group (GT ≤ 100 μm, n=13 eyes) and a DSAEK group (GT > 100 μm, n=21 eyes). The groups were compared with regard to best-corrected visual acuity (BCVA), subjective refraction, central corneal thickness (CCT), GT, and endothelial cell density (ECD). Results. Preoperative BCVA (logMAR) was 1.035 ± 0.514 and 0.772 ± 0.428 for UT-DSAEK and DSAEK, respectively (P=0.072). At 6 months postoperatively, BCVA was 0.088 ± 0.150 following UT-DSAEK and 0.285 ± 0.158 following DSAEK (P=0.001). Conclusion. DSAEK grafts with a thickness under 100 μm offered better visual outcomes during the early postoperative period.

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Hsiao, Chen, Meir, et al. "Clinical Outcomes of Penetrating Keratoplasty and Descemet Stripping Automated Endothelial Keratoplasty in Asian Population with American Corneas." International Journal of Environmental Research and Public Health 16, no. 22 (2019): 4547. http://dx.doi.org/10.3390/ijerph16224547.

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To determine the comparative efficacy and safety of penetrating keratoplasty (PK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the Asian population receiving imported donor corneas, our single-center retrospective study provides analysis supporting the transition from PK to DSAEK in the Asian population using imported American donor corneas. We analyzed 259 patients with 241 and 57 cases of PK and DSAEK respectively during 2008 to 2017 using imported corneas at Chang Gung Memorial Hospital, Linkou, Taiwan. In terms of long-term graft survival analysis, there was no difference between PK and DSAEK (log-rank p = 0.386, HR = 0.920, 95% CI: [0.641–1.380]). However, Cox proportional regression analysis revealed that corneal survival rate of DSAEK group in the first 100 days after transplantation was inferior than that of PK group (log-rank p < 0.001, HR = 2.733, 95% CI: [1.501–4.977])]. Despite the inferior survival rate, there were significantly less neovascularization and Descemet membrane folds in the DSAEK group. Importantly, the non-complication rate of DSAEK was much higher than that of PK with significant difference (PK, 25.7% vs DSAEK 42.0%, p = 0.022). Collectively, DSAEK is suggested as an alternative surgical modality in Asian patients using imported American donor corneas because of less complication, and no difference in long-term corneal graft survival rates between PK and DSAEK.

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Taravella, Michael J., Vipul Shah, and Richard Davidson. "Ultrathin DSAEK." International Ophthalmology Clinics 53, no. 2 (2013): 21–30. http://dx.doi.org/10.1097/iio.0b013e31827823a8.

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Castellucci, Massimo, Costanza Novara, Alessandra Casuccio, et al. "Bilateral Ultrathin Descemet’s Stripping Automated Endothelial Keratoplasty vs. Bilateral Penetrating Keratoplasty in Fuchs’ Dystrophy: Corneal Higher-Order Aberrations, Contrast Sensitivity and Quality of Life." Medicina 57, no. 2 (2021): 133. http://dx.doi.org/10.3390/medicina57020133.

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Background and Objectives: The objective of this paper is to compare the visual outcomes and quality of life (QoL) after bilateral ultrathin Descemet’s stripping automated endothelial keratoplasty (UT-DSAEK) with bilateral penetrating keratoplasty (PK) for Fuchs’ endothelial dystrophy (FED). Materials and Methods: Retrospective comparative cohort study, including 11 patients with FED who underwent bilateral PK and 13 patients with FED who underwent bilateral UT-DSAEK. All patients were already pseudophakic or had undergone a combined cataract procedure. The main outcomes were corrected distance visual acuity (CDVA) corneal higher-order aberrations (HOAs), contrast sensitivity (CS) and quality of life (QoL). Results: The mean follow-up after the second eye surgery was 32.5 ± 10.2 months in PK and 19.6 ± 8.6 months in UT-DSAEK patients. The CDVA in the UT-DSAEK group was significantly better than in the PK one (0.18 ± 0.07 vs. 0.35 ± 0.16 logMAR, p < 0.0001). The mean anterior corneal total HOAs of the central 5 mm were significantly lower in UT-DSAEK eyes than in PK eyes (0.438 ± 0.078 µ and 1.282 ± 0.330 µ respectively, p < 0.0001), whilst the mean posterior total HOAs did not differ between groups (0.196 ± 0.056 µ and 0.231 ± 0.089 µ, respectively, p = 0.253). The CS was lower at 0.75 and 1.5 cycles/degree in P the K group when compared to the DSAEK one (p = 0.008 and 0.005, respectively). The QoL scores by the NEI RQL-42 test exhibited better values in DSAEK patients in 9 out of 13 scales. Conclusion: Our study confirms that UT-DSAEK provides a better visual function in terms of CDVA and CS, together with lower HOAs, when compared to PK. Hence, the vision-related QoL, binocularly evaluated by the NEI RQL-42 items, indicates a higher satisfaction in UT-DSAEK eyes.

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Dapena, Isabel, Lisanne Ham, and Gerrit RJ Melles. "Endothelial keratoplasty: DSEK/DSAEK or DMEK - the thinner the better?" Current Opinion in Ophthalmology 20, no. 4 (2009): 299–307. http://dx.doi.org/10.1097/icu.0b013e32832b8d18.

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Smyth, Aoife, Grace Anne McCabe, Patrick Murtagh, and Elizabeth Margaret McElnea. "Tectonic Descemet’s stripping automated endothelial keratoplasty for corneal perforation." BMJ Case Reports 15, no. 4 (2022): e247345. http://dx.doi.org/10.1136/bcr-2021-247345.

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We report the use of Descemet stripping automated endothelial keratoplasty (DSAEK) for the treatment of sterile corneal perforation after trauma. In an eye with corneal perforation and cataract due to trauma, cataract surgery and DSAEK were performed. Corneal integrity was promptly restored and the patient avoided tectonic anterior lamellar and penetrating keratoplasty. DSAEK may be performed for the management of corneal perforation.

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Romano, Vito, Luca Pagano, Kunal A. Gadhvi, et al. "Clinical outcomes of pre-loaded ultra-thin DSAEK and pre-loaded DMEK." BMJ Open Ophthalmology 5, no. 1 (2020): e000546. http://dx.doi.org/10.1136/bmjophth-2020-000546.

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ObjectiveTo compare clinical outcomes and complications between pre-loaded ultra-thin Descemet stripping automated endothelialkeratoplasty (pl-UT-DSAEK) and pre-loaded Descemet membrane endothelial keratoplasty (pl-DMEK).Methods and analysisComparative study in patients with endothelial dysfunction associated with Fuchs endothelial corneal dystrophy and pseudophakic bullous keratopathy who underwent pl-UT-DSAEK or pl-DMEK transplants. For both groups, the tissues were pre-loaded at the Fondazione Banca degli Occhi del Veneto (Venice, Italy) and shipped to The Royal Liverpool University Hospital (Liverpool, UK). Best corrected visual acuity (BCVA) and re-bubbling rates were the main outcome measures.Results56 eyes of 56 patients were included. 31 received pl-UT-DSAEK and 25 received pl-DMEK. At 12 months, BCVA (LogMAR) was significantly better for pl-DMEK (0.17±0.20 LogMAR) compared with pl-UT-DSAEK (0.37±0.37 LogMAR, p<0.01). The percentage of people that achieved ≥20/30 was significantly higher in the pl-DMEK group. The rate of re-bubbling, however, was significantly higher for pl-DMEK (44.0%) than for Pl-UT-DSAEK (12.9%), p<0.01.ConclusionPl-DMEK offers better BCVA than pl-UT-DSAEK. The higher re-bubbling rate associated with pre-loaded DMEK is of concern.

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Abicca, Irene, Marta Gilardi, Daniela Giannini, Rossella Anna Maria Colabelli Gisoldi, Augusto Pocobelli, and Domenico Schiano Lomoriello. "Corneal Subbasal Plexus in Eyes with Fuchs’ Endothelial Corneal Dystrophy after Two Different Endothelial Surgeries." Journal of Ophthalmology 2021 (October 4, 2021): 1–6. http://dx.doi.org/10.1155/2021/5098272.

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Purpose. To evaluate the morphological features and density of corneal subbasal plexus (SBP) using in vivo corneal confocal microscopy (IVCCM) in patients affected by Fuchs’ endothelial corneal dystrophy (FECD) six months after Descemet membrane endothelial keratoplasty (DMEK) and Descemet-stripping automated endothelial keratoplasty (DSAEK). Methods. We included patients affected by FECD, requiring corneal endothelial surgery due to corneal oedema occurred from 3 to 6 months. 7 eyes underwent DMEK and 7 eyes DSAEK. All patients performed IVCCM preoperative and in six months postoperative. We analyzed SBP parameters, using CS4 Nerves Tracking Tool, and we studied the differences between the two endothelial keratoplasties. Results. Comparing the eyes treated with DMEK with those treated with DSAEK, preoperative corneal thickness, corrected distance visual acuity (CDVA), and age were similar in both groups. SBP was not detectable at preoperative IVCCM in any eye. Postoperatively, the nerve fibers length, the nerve fibers density, the tortuosity, and the number of fibers and of branching did not differ in the eyes that underwent DMEK compared to DSAEK. The corneal beadings density was higher after DMEK than DSAEK, and this difference was statistically significant ( P = 0.004). The type of endothelial keratoplasty was not associated with the presence or absence of postoperative corneal SBP (Pearson’ chi-square, 0.755). Conclusions. Postoperative corneal reinnervation should be easily and noninvasively studied using IVCCM. Morphological postoperative features of SBP did not differ between two different types of endothelial keratoplasty, DMEK and DSAEK, despite the different sizes of the corneal incision. The lower beading density in the DSAEK group should be the consequence of a different distribution of mitochondria along the nerve fibers, as expression of a supposed higher metabolic distress in the DSAEK group.

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Li, Chendi, Wenyu Wu, Gege Xiao, Vishal Jhanji, Jing Hong, and Yun Feng. "Descemet Stripping Automated Endothelial Keratoplasty in Thick Corneas." Journal of Clinical Medicine 11, no. 19 (2022): 5601. http://dx.doi.org/10.3390/jcm11195601.

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Purpose: To evaluate the outcomes of Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) in corneas > 820 microns in thickness. Methods: This retrospective study included 30 eyes of 30 patients who underwent DSAEK. Endothelial cell destiny (ECD) and corneal thickness were recorded before surgery and at 1 and 12 months postoperatively. Patients were divided into two groups (≤ 820 microns and > 820 microns) based on median preoperative corneal thickness. Linear regression analyses were used to investigate the correlations between ECD and preoperative corneal thickness. Results: Recipient corneal thickness (RCT) and postoperative central cornea thickness had a statistically significant difference 1 month after surgery (p = 0.03, p = 0.08, respectively). BCVA and ECD did not have a statistical difference in the two groups at 1 month and 12 months after DSAEK. Conclusions: BCVA, ECD and corneal thickness were similar at 12 months after DSAEK in thick corneas. DSAEK is a viable surgical option in thick corneas.

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Melki, Samir A., Mona Harissi-Dagher, Simon Wu, and Mark A. Fava. "Viscoelastic-Assisted DSAEK." Ophthalmology 118, no. 5 (2011): 1003–4. http://dx.doi.org/10.1016/j.ophtha.2010.12.026.

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Kim, Ryan S., and Gene Kim. "Double Descemet Stripping Automated Endothelial Keratoplasty (DSAEK): Secondary DSAEK Without Removal of the Failed Primary DSAEK Graft." Ophthalmology 126, no. 9 (2019): 1218. http://dx.doi.org/10.1016/j.ophtha.2019.05.020.

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Cho, Yeonwoo, SoonWon Yang, Doh Hoon Chung, et al. "Comparison of Penetrating Keratoplasty and Descemet Stripping Automated Endothelial Keratoplasty in Eyes with Glaucoma Ahmed Valve implants." Journal of the Korean Ophthalmological Society 63, no. 3 (2022): 242–50. http://dx.doi.org/10.3341/jkos.2022.63.3.242.

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Purpose: To compare the clinical outcomes of penetrating keratoplasty (PKP) and Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with Glaucoma Ahmed Valve implants.Methods: The charts of 11 patients who underwent PKP and 11 who underwent DSAEK between February 2016 and June 2018 were retrospectively reviewed; all patients previously underwent Ahmed valve implant surgery. The best corrected visual acuity, intraocular pressure, and endothelial cell count were compared 1, 3, and 6 months after surgery. Graft rejection and graft failure were also evaluated during follow-up. The survival rates were compared using Kaplan–Meier survival analysis.Results: The difference in graft survival rates of the PKP and DSAEK groups was not significant (p = 0.295); however, graft failure occurred earlier in the PKP group (12.9 ± 10.1 vs. 18.8 ± 5.3 months). The postoperative best corrected visual acuity of the PKP group had improved at 1 (p = 0.027) and 3 (p = 0.017) months, while the DSAEK group showed significant improvement at 1, 3, and 6 months (all p = 0.005). Intergroup analysis showed better visual prognosis of the DSAEK group at 1, 3, and 6 months after surgery (p = 0.023, p = 0.007, and p = 0.004, respectively).Conclusions: In our study, the two corneal transplantation methods did not have significantly different graft survival rates; however, graft failure occured later in the DSAEK group and the postoperative visual acuity was better than in the PKP group. Although further study is needed, performing DSAEK in patients with an Ahmed valve implant seems to be a good alternative to PKP.

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Torras-Sanvicens, Josep, Irene Blanco-Domínguez, José-María Sánchez-González, et al. "Visual Quality and Subjective Satisfaction in Ultrathin Descemet Stripping Automated Endothelial Keratoplasty (UT-DSAEK) versus Descemet Membrane Endothelial Keratoplasty (DMEK): A Fellow-Eye Comparison." Journal of Clinical Medicine 10, no. 3 (2021): 419. http://dx.doi.org/10.3390/jcm10030419.

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Background: To analyze objective and subjective visual quality differences between descemet membrane endothelial keratoplasty (DMEK) and ultra-thin descemet stripping automated endothelial keratoplasty (UT-DSAEK) with a paired contralateral-eye design. Methods: A cross-sectional, comparative, and observational case series study between DMEK and UT-DSAEK were presented. Visual acuity, refractive status and corneal quality assessment were compared between both endothelial keratoplasty techniques. The sample consisted of 20 eyes (10 patients) diagnosed with Fuchs endothelial corneal dystrophy. All measurements were performed preoperatively and at six months after surgery. Analyzed data included the measurement of objective scattering index, modulation transfer function, Strehl ratio, and optical quality assessment (OQAS) values. Contrast sensitivity, subjective patient satisfaction, visual acuity, tomography, pachymetry, endothelial cell count, and refraction status were also analyzed. Results: Objective and subjective visual quality variables had similar results among UT-DSAEK and DMEK procedures. Statistically significant differences favoring DMEK against UT-DSAEK were found in endothelial cell density (658.80 ± 139.33 and 1059.00 ± 421.84 cells/mm2, respectively), pachymetry (621.20 ± 33.74 and 529.70 ± 30.00 µm, respectively), and follow-up (45.50 ± 24.76 and 15.50 ± 8.43 months, respectively). Conclusions: UT-DSAEK and DMEK revealed no differences in terms of objective and subjective visual quality. However, DMEK showed a faster recovery during the follow-up, increased endothelial cell density, lower pachymetry, and a more anatomical posterior keratometry against UT-DSAEK in this case series paired-eye study.

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Hwang, Anita M., and Jimmy K. Lee. "Descemet-stripping Automated Endothelial Keratoplasty—A Review." US Ophthalmic Review 04, no. 01 (2011): 80. http://dx.doi.org/10.17925/usor.2011.04.01.80.

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Descemet-stripping automated endothelial keratoplasty (DSAEK) has become the procedure of choice to treat corneal endothelial dysfunction. The technique involves replacing the diseased host endothelium with a graft consisting of a thin layer of posterior stroma, Descemet membrane, and endothelium. In comparison to penetrating keratoplasty (PK), DSAEK confers quicker visual and structural recovery with absence of corneal surface incisions or sutures, and limits astigmatism. DSAEK has been proved to successfully achieve favorable visual acuity and graft clarity in bullous keratopathy, posterior polymorphous dystrophy, and failed PK grafts. This article discusses various DSAEK surgical techniques, short- and longterm post-surgical results, complications, and comparisons with other types of keratoplasty. With the advent of Descemet membrane endothelial keratoplasty (DMEK), in which only Descemet membrane is transplanted, visual rehabilitation may be attained sooner.

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Hwang, Anita M., and Jimmy K. Lee. "Descemet’s Stripping Automated Endothelial Keratoplasty – A Review." European Ophthalmic Review 03, no. 02 (2009): 71. http://dx.doi.org/10.17925/eor.2009.03.02.71.

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Descemet’s stripping automated endothelial keratoplasty (DSAEK) has become the procedure of choice to treat corneal endothelial dysfunction. The technique involves replacing the diseased host endothelium with a graft consisting of a thin layer of posterior stroma, Descemet’s membrane and endothelium. In comparison with penetrating keratoplasty (PK), DSAEK confers quicker visual and structural recovery with absence of corneal surface incisions or sutures, and also limits astigmatism. DSAEK has been proved to successfully achieve favourable visual acuity and graft clarity in bullous keratopathy, posterior polymorphous dystrophy and failed PK grafts. This literature review discusses various DSAEK surgical techniques, short- and long-term post-surgical results, complications and comparisons with other types of keratoplasty. With the advent of Descemet’s membrane endothelial keratoplasty (DMEK), in which only Descemet’s membrane is transplanted, visual rehabilitation may be attained sooner.

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Singh, Tanu, Parul Ichhpujani, Rohan Bir Singh, Sudesh Arya, and Suresh Kumar. "Is ultra-thin Descemet stripping automated endothelial keratoplasty a viable alternative to Descemet membrane endothelial keratoplasty? A systematic review and meta-analysis." Therapeutic Advances in Ophthalmology 15 (January 2023): 251584142211478. http://dx.doi.org/10.1177/25158414221147823.

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Background: Ultra-thin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) is a recently developed surgical procedure that has shown promising results for the management of various corneal endothelial diseases. Objectives: To evaluate the outcomes of the UT-DSAEK to the Descemet membrane endothelial keratoplasty (DMEK). Design: A systematic analysis of the studies comparing UT-DSAEK with DMEK by evaluating one or more outcomes (vision, complications, and post-operative endothelial cell counts) was performed. The meta-analysis was done if two or more studies reported a common outcome. Methods: We used PubMed, EMBASE, and SCOPUS databases to identify articles comparing the outcomes of UT-DSAEK with DMEK and performed a meta-analysis using RevMan, version 5.4. Results: A total of six studies were included in this review (two randomized clinical trials and four non-randomized comparative studies). Our analysis showed the patients who underwent DMEK cases showed better visual outcomes with a mean difference of 0.06 LogMAR (95% CI: 0.04–0.09) in BCVA, albeit with i2 of 52% (heterogenous values). The evidence was weak, with the most weightage on retrospective studies. UT-DSAEK showed significantly fewer complications such as graft dislocations, with an odds ratio of 0.25 (95% CI: 0.13–0.48). There was no significant difference in the endothelial cell counts with a mean difference of 86.34 (95%CI: –133.09 to –305.77). Conclusion: Although the literature is limited on UT-DSAEK with post-operative visual acuity that could be practically at par with DMEK, lesser complication rates and comparable post-operative endothelial cells could be a suitable alternative to DMEK for corneal endothelial pathologies.

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Omoto, Takashi, Chisato Agata, Reina Akiyama, et al. "Iridotrabecular and Iridocorneal Contact Changes after Cataract Surgery and Endothelial Keratoplasty in Bilateral Iridoschisis." Case Reports in Ophthalmology 12, no. 1 (2021): 198–203. http://dx.doi.org/10.1159/000513793.

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We report a case of bilateral iridoschisis with corneal oedema and a quantitative evaluation of the changes in iridotrabecular and iridocorneal contact before and after cataract surgery and after Descemet stripping automated endothelial keratoplasty (DSAEK). A 76-year-old woman with iridoschisis and cataracts, previously managed with laser iridotomy, experienced progressive vision loss. The preoperative iridotrabecular contact (ITC) index measured by anterior segment optical coherence tomography was 23.6% in the right eye and 24.4% in the left eye. Preoperative corneal oedema in the right eye was more severe than that in the left eye. Cataract surgery, followed by DSAEK, was performed in the right eye and subsequently in the left eye. Her visual acuity improved postoperatively, and the corneal oedema of both eyes was treated successfully. Moreover, the ITC index improved in both eyes, to 4.7 and 6.9% after cataract surgery and to 0 and 0% after DSAEK in the right and left eyes, respectively. Staged cataract surgery and DSAEK were effective for endothelial decompensation caused by iridoschisis. Additionally, we confirm that iridotrabecular and iridocorneal contacts improved after both surgical procedures not only after cataract surgery but also after DSAEK. This case report showed the clinical usefulness of the ITC index in the detection of changes after different surgical procedures.

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Graffi, Shmuel, Pia Leon, Yoav Nahum, et al. "Outcomes of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) performed in eyes with failure of primary Descemet membrane endothelial keratoplasty (DMEK)." British Journal of Ophthalmology 103, no. 5 (2018): 599–603. http://dx.doi.org/10.1136/bjophthalmol-2017-311834.

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AimTo evaluate the outcomes of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) performed in eyes after failure of primary Descemet membrane endothelial keratoplasty (DMEK).MethodsThis was a retrospective, non-comparative interventional case series done in a tertiary care hospital. The study group included 21 eyes of patients which underwent UT-DSAEK following the failure of primary DMEK. Outcome measures included best spectacle-corrected visual acuity (BSCVA) and endothelial cell density (ECD) both recorded 6 and 12 months postoperatively as well as central graft thickness (CGT) measured 6 months after UT-DSAEK.ResultsWhen considering only eyes without comorbidities (17 of 21), 12 months after UT-DSAEK, BSCVA was ≥20/25 in 12/13 (92%) eyes and ≥20/20 in 4/13 (30%) eyes. Mean ECD loss rate was 38.9% at 12 months postoperatively (range 8%–57%). Six months postoperatively, CGT averaged at 81±34 µm (range 34–131 µm). No intraoperative complications were recorded. Postoperatively, one patient (no. 8) had graft wrinkles that were fixed 2 days following UT-DSAEK. Four patients have developed intraocular lens (IOL) opacification, and two of them underwent IOL exchange. No other postoperative complications were recorded.ConclusionsUT-DSAEK is instrumental in the management of primary DMEK graft failure, allowing visual rehabilitation which is comparable with that of repeat DMEK.

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Salvetat, Maria L., Marco Zeppieri, Flavia Miani, and Paolo Brusini. "Postkeratoplasty Anterior and Posterior Corneal Surface Wavefront Analysis: Descemet’s Stripping Automated Endothelial Keratoplasty versus Penetrating Keratoplasty." ISRN Ophthalmology 2013 (September 12, 2013): 1–8. http://dx.doi.org/10.1155/2013/210565.

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Purpose. To compare the higher-order aberrations (HOAs) due to the anterior and posterior corneal surfaces in patients that underwent either Descemet-stripping-automated-endothelial-keratoplasty (DSAEK) or penetrating keratoplasty (PK) for endothelial dysfunction and age-matched controls. Methods. This retrospective, observational, case series included 28 patients after PK, 30 patients after DSAEK, and 30 healthy controls. A Scheimpflug imaging system was used to assess the HOAs due to the anterior and posterior corneal surfaces at 4 mm and 6 mm optical zones. Total, 3rd and 4th order HOAs were considered. Intra- and intergroup differences were assessed using the Friedman and the Kruskal-Wallis tests, respectively; paired comparisons were performed using Duncan's multiple range test. Results. Total, 3rd and 4th order HOAs due to both corneal surfaces at 4 mm and 6 mm optical zones were significantly higher in the PK group, intermediate in the DSAEK group, and lower in controls (). The most important HOAs components in both PK and DSAEK groups were trefoil and coma from the anterior corneal surface () and trefoil from the posterior corneal surface (). Conclusions. The optical quality of both corneal surfaces appeared significantly higher after DSAEK than after PK, which can increase the postoperative patient's quality of vision and satisfaction.

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Soleimani, Mohammad, Seyed Ali Tabatabaei, and Reza Mirshahi. "A New User-Friendly and Affordable Method in Descemet Stripping Endothelial Keratoplasty." Open Ophthalmology Journal 12, no. 1 (2018): 242–46. http://dx.doi.org/10.2174/1874364101812010242.

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Aims: To describe a new technique in Descemet Stripping Automated Endothelial Keratoplasty (DSAEK). Materials and Methods: In this technique, we use easily available materials (mainly a Nelaton tube) to make an injector for loading DSAEK lenticule and also easily pulling it (using a gauge 23 needle) into the eye. In this paper, we report outcomes of this technique in four cases. Results: Using these available instruments could easily lead to a clear postoperative cornea. Mean Endothelial Cell Density (ECD) loss at sixth postoperative month was 26%. Conclusion: We proposed a novel effective user-friendly and affordable technique to perform DSAEK.

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Bijon, Jacques, Myrsini Petrelli, Basile Salmon, Kattayoon Hashemi, and George D. Kymionis. "Combined Astigmatic Arcuate Keratotomy with Descemet Automated Endothelial Keratoplasty." Case Reports in Ophthalmology 12, no. 2 (2021): 640–45. http://dx.doi.org/10.1159/000517741.

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We report the results of simultaneous astigmatic arcuate keratotomy (AK) and Descemet automated endothelial keratoplasty (DSAEK). A 55-year-old patient with a history of high myopia was referred for the management of bullous keratopathy secondary to an anterior chamber phakic intraocular lens (pIOL). IOL explantation through a 5.5-mm corneal incision, cataract extraction, and posterior chamber IOL implantation, combined with DSAEK, were performed. Postoperatively, increased astigmatism up to 2.0 diopters (Dpt) was observed, attributed to the large corneal incision, and remained stable, despite suture removal at 3 months. One year postoperatively, the graft showed signs of progressive endothelial dysfunction. A combined procedure of astigmatic AK and DSAEK was thus performed. After 6 months, topographic astigmatism was significantly reduced to 0.5 Dpt and best-corrected visual acuity increased. In conclusion, simultaneous astigmatic AK and DSAEK could be an effective combination for treating patients with well-documented pre-existing astigmatism and endothelial decompensation.

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Miyakoshi, Akio, Hironori Ozaki, Mitsuya Otsuka, and Atsushi Hayashi. "Efficacy of Intraoperative Anterior Segment Optical Coherence Tomography during Descemet's Stripping Automated Endothelial Keratoplasty." ISRN Ophthalmology 2014 (February 2, 2014): 1–4. http://dx.doi.org/10.1155/2014/562062.

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Purpose. To examine the graft-host interface during Descemet's stripping automated endothelial keratoplasty (DSAEK) surgery with optical coherence tomography (OCT). Design. Prospective, interventional case series. Patients and Methods. Eight patients who underwent a DSAEK were included. A handheld OCT was used intraoperatively to examine the presence of interface fluid between the host cornea and the graft. Results. In 3 patients, no interface fluid was detected between the host cornea and the graft after the graft was attached by air injection. In 4 patients, interface fluid was detected after the graft was attached by air injection. The remaining interface fluid was drained through corneal stab incisions. One patient required a second surgery because the first surgery failed due to persistence of the interface fluid. All patients showed a complete attachment of the graft at one month after the DSAEK surgery. Conclusion. A handheld OCT is useful to detect the interface fluid between the host cornea and the graft during a DSAEK.

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Wakimasu, Koichi, Koji Kitazawa, Kanae Kayukawa, et al. "Five-year follow-up outcomes after Descemet’s stripping automated endothelial keratoplasty: a retrospective study." BMJ Open Ophthalmology 5, no. 1 (2020): e000354. http://dx.doi.org/10.1136/bmjophth-2019-000354.

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ObjectiveTo assess graft survival and endothelial cell density (ECD) over a 5-year follow-up period after Descemet’s stripping automated endothelial keratoplasty (DSAEK).Methods and analysisThis retrospective study involved 130 eyes of 130 consecutive patients with Fuchs endothelial corneal dystrophy (FECD), non-FECD bullous keratopathy (BK) (non-FECD) or BK post-trabeculectomy or tube-shunt surgery (glaucoma with bleb) who underwent DSAEK between August 2007 and January 2012 and were followed for more than 5 years postoperatively. Patients with previous keratoplasty, graft suture failure, primary graft failure, postoperative endophthalmitis and ocular infection were excluded. Graft survival and ECD was then examined in all patients who underwent DSAEK and completed the postoperative follow-up period. The association between clinical factors and 5-year graft survival after DSAEK was analysed with multivariate logistic regression analysis.ResultsThe overall graft survival rate at 5 years postoperatively was 85%, yet significantly poorer in the glaucoma with bleb eyes (47%) than in the FECD (100%) or non-FECD (90%) eyes (p<0.01, log-rank test). In the FECD, non-FECD and glaucoma with bleb eyes, the mean ECD at 5 years postoperatively was 1054 cells/mm2, 1137 cells/mm2 and 756 cells/mm2, respectively. Multivariate logistic regression analysis showed history of trabeculectomy or tube-shunt surgery and postoperative allograft rejection to be negative factors for graft survival at 5 years after DSAEK (OR 0.01, 95% CI 0.00 to 0.10 and OR 0.02, 95% CI 0.00 to 0.33, respectively).ConclusionOur findings show that at 5 years postoperatively, the surgical outcome after DSAEK was poorer in eyes after trabeculectomy or tube-shunt surgery.Trial registration numberUMIN000024891.

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Hindman, Holly B., Krystel R. Huxlin, Seth M. Pantanelli, et al. "Post-DSAEK Optical Changes." Cornea 32, no. 12 (2013): 1567–77. http://dx.doi.org/10.1097/ico.0b013e3182a9b182.

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del Hierro Zarzuelo, A., and A. Boto de los Bueis. "Iris alterations after DSAEK." Archivos de la Sociedad Española de Oftalmología (English Edition) 91, no. 9 (2016): 422–25. http://dx.doi.org/10.1016/j.oftale.2016.05.003.

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Cursiefen, C., and F. E. Kruse. "Posteriore lamelläre Keratoplastik (DSAEK)." Der Ophthalmologe 105, no. 2 (2008): 183–92. http://dx.doi.org/10.1007/s00347-007-1680-0.

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Cursiefen, C., and F. E. Kruse. "Posteriore lamelläre Keratoplastik (DSAEK)." Der Ophthalmologe 106, no. 10 (2009): 939–54. http://dx.doi.org/10.1007/s00347-009-2024-z.

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Schaub, Friederike, Philip Enders, Sigrid Roters, Claus Cursiefen, and Björn O. Bachmann. "Single-pass Ultrathin DSAEK (UT-DSAEK) with the SLc Expert Microkeratome®." Acta Ophthalmologica 95, no. 2 (2016): e160-e161. http://dx.doi.org/10.1111/aos.13211.

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Ho, Dawn, Charmaine Chai, Hazel Lin, et al. "Optical and Tectonic Corneal Transplant Outcomes in a Tertiary Hospital in Singapore within the Singapore Corneal Transplant Registry." Annals of the Academy of Medicine, Singapore 47, no. 3 (2018): 92–100. http://dx.doi.org/10.47102/annals-acadmedsg.v47n3p92.

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Introduction: This study aimed to describe and compare corneal graft survival and optical outcomes following deep anterior lamellar keratoplasty (DALK) and Descemet's stripping automated endothelial keratoplasty (DSAEK) with penetrating keratoplasty (PK), and to document tectonic success of patch grafts. Materials and Methods: This was a retrospective, non-randomised, comparative and descriptive cohort study. A total of 139 eyes that underwent primary keratoplasty between 2000 and 2016 were included, and the following data was extracted: demographics, clinical diagnosis and primary indication, pre- and intraoperative risk factors, postkeratoplasty outcomes, and complications. Optical success was defined as good graft clarity and best corrected visual acuity (BCVA) of 6/12 or better. Graft failure was defined as irreversible corneal oedema and loss of clarity. Tectonic success in patch grafts was defined as tectonic integrity with no repeat tectonic surgical procedure required in the postoperative period. Results: The mean follow-up duration was 3.24 ± 3.47 years in the PK group (n = 16), 1.89 ± 0.86 years in the DALK group (n = 37), 2.36 ± 1.24 years in the DSAEK group (n = 53), and 2.17 ± 1.09 years in the patch graft group (n = 33). The 3-year probabilities of survival for PK, DALK, DSAEK and patch graft were 60.9%, 94.1%, 89.9%, and 67.1%, respectively. The overall percentage of complications was significantly higher for PK (81.3%), compared to DALK (48.6%), DSAEK (49.1%), and patch graft (21.2%). In the PK and DALK groups, 100% achieved BCVA of 6/12 or better, while in the DSAEK group, 96.43% achieved BCVA of 6/12 or better. Conclusion: From a similar study cohort of Asian eyes, graft survival was superior and complications were reduced for DALK and DSAEK compared to PK, but optical outcomes were comparable. Graft survival for patch graft was expectedly lower, but the incidence of complications was low. Key words: Cornea, Keratoplasty, Survival

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Lehman, Roy E., Laurel A. Copeland, Eileen M. Stock, and Samuel F. Fulcher. "Graft Detachment Rate in DSEK/DSAEK After Same-Day Complete Air Removal." Cornea 34, no. 11 (2015): 1358–61. http://dx.doi.org/10.1097/ico.0000000000000617.

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van Rooij, Jeroen, Angela Engel, Lies Remeijer, Hugo van Cleijnenbreugel, and René Wubbels. "Long-Term Functional and Anatomical Outcome after Descemet Stripping Automated Endothelial Keratoplasty: A Prospective Single-Center Study." Journal of Ophthalmology 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/7320816.

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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/mm2per 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.

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Hosny, Mohamed H., Ayah Marrie, M. Karim Sidky, Sherif GamalEldin, and Mohsen Salem. "Results of Femtosecond Laser-Assisted Descemet Stripping Automated Endothelial Keratoplasty." Journal of Ophthalmology 2017 (2017): 1–11. http://dx.doi.org/10.1155/2017/8984367.

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Purpose. To evaluate femtosecond laser in DSAEK surgery as an improvement to manual DSAEK. Settings. Department of Ophthalmology, Cairo University. Design. A retrospective observational clinical study. Methods. 20 eyes with SBK and Fuchs’ dystrophy underwent a Femto-assisted DSAEK by laser cutting of two matching posterior stromal discs in the recipient and donor corneas and then fitting the donor disc in the posterior corneal defect of the recipient using Busin’s glide or Terry forceps. Results. Corneal thickness decreased significantly from a mean of 900-micron preoperative values (900.7 m) to 562 m postoperatively. Evidence of side healing was documented by OCT. One patient had a double AC, one patient had an air interface entrapment “Double Bubble,” one patient had a fungal infection and was treated by a therapeutic penetrating keratoplasty, and one patient had a CMO. Conclusion. Femtolaser-assisted DSAEK may be superior to manual techniques as it offers better centration, thinner graft/host complex, earlier corneal detergecense, and stronger healing. This study was registered at Researchregistry.com with a UID: researchregistry2274.

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Machalińska, Anna, Agnieszka Kuligowska, Bogna Kowalska, and Krzysztof Safranow. "Comparative Analysis of Corneal Parameters in Swept-Source Imaging between DMEK and UT-DSAEK Eyes." Journal of Clinical Medicine 10, no. 21 (2021): 5119. http://dx.doi.org/10.3390/jcm10215119.

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Background: The need to provide a comparative analysis of corneal parameter changes compared to their preoperative values between Descemet membrane endothelial keratoplasty (DMEK) and ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) patients. Methods: The study included 24 eyes after UT-DSAEK and 24 eyes after DMEK. Visual acuity, endothelial cell count (ECC), central corneal thickness (CCT), mean keratometry (MK), mean astigmatism (MA), astigmatism asymmetry (AA) and higher-order aberrations (HOAs) were assessed at baseline and 1, 3, 6 and 12 months after the surgery. Results: From the 3rd month post operation, ECC was higher in the DMEK eyes than in the UT-DSAEK eyes (p = 0.01). In a bivariate analysis that was adjusted for age, DMEK was associated with a smaller decrease in posterior MK at the 1-month (β = −0.49, p = 0.002), 3-month (β = −0.50, p < 0.001), 6-month (β = −0.58, p < 0.001) and 12-month (β = −0.49, p < 0.001) follow-up visits. There were no significant differences in changes in anterior or combined surface MK throughout the observation period. Accordingly, no significant differences in changes in MA, AA or HOAs compared to the baseline values were identified between the eyes after DMEK and UT-DSAEK at any follow-up time point. Conclusions: UT-DSAEK seemed to be an easier and safer technique than DMEK while maintaining similar outcomes regarding irregular astigmatism and total keratometry values.

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Jastaneiah, Sabah S. "Descemet’s Stripping-Automated Endothelial Keratoplasty for Traumatic Aniridia and Aphakia." Case Reports in Ophthalmological Medicine 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/982657.

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This Interventional case reports a challenging case of descemet’s stripping-automated endothelial keratoplasty (DSAEK) in a young male patient with traumatic aniridia, aphakia, and corneal edema. Surgery was planned in two stages; first was implantation of aniridia intraocular lens (AIOL), few months later, DSAEK procedure was performed. Successful outcome of both procedures was achieved as measured by the stability of the AIOL, clarity of the cornea, attachment of the lenticule, and improvement in vision. Aniridia implant supports a sufficient amount of air in the anterior chamber especially if the posterior segment is well formed, while providing the required lens power to improve vision. DSAEK procedure challenges that include iris defects and aphakia may be overcome by stepwise planning of the procedure.

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Kate, Anahita, and Sayan Basu. "Case Report: Primary graft failure due to a reversed lenticule in Descemet Stripping Automated Endothelial Keratoplasty." F1000Research 11 (September 27, 2022): 1105. http://dx.doi.org/10.12688/f1000research.123313.1.

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Introduction and importance: This report details the clinical features and management in a case of Descemet stripping automated endothelial keratoplasty (DSAEK) which had primary graft failure (PGF) due to an inverted yet attached lenticule. Presentation of case: A 66-year-old gentleman had poor visual recovery in the right eye after undergoing cataract surgery 12 years prior to presentation. The visual acuity was counting fingers and examination revealed endothelial decompensation. The patient underwent a DSAEK and postoperatively had a well attached lenticule. However, the cornea was edematous three weeks after the surgery and optical coherence tomography (OCT) revealed a reversed lenticule. The patient underwent a repeat DSAEK and had an uneventful postoperative course. The visual acuity was 20/40 after 7 months with a clear cornea and a well attached graft. Discussion: PGF is a rare complication following DSAEK which occurs due to poor endothelial function of the donor graft. Insertion of a reversed lenticule may get overlooked as a cause of PGF unless the graft edge profile is examined on an OCT scan. The graft in the current case was well attached despite its inverted position suggesting that graft adherence is perhaps not a function of the corneal endothelial pumps in isolation and may be driven by factors such as the intraocular pressure. Conclusion: A reversed DSAEK lenticule may have normal adherence to the host stroma and must be considered in cases with PGF. OCT of the graft edge is required for diagnosis before performing a repeat keratoplasty.

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Kitazawa, Koji, Passara Jongkhajornpong, Tsutomu Inatomi, et al. "Topical ganciclovir treatment post-Descemet’s stripping automated endothelial keratoplasty for patients with bullous keratopathy induced by cytomegalovirus." British Journal of Ophthalmology 102, no. 9 (2018): 1293–97. http://dx.doi.org/10.1136/bjophthalmol-2017-311145.

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Background/aimsTo investigate the efficacy of topical ganciclovir (GCV) for preventing disease recurrence and improving the surgical outcome post-Descemet’s stripping automated endothelial keratoplasty (DSAEK) in patients with cytomegalovirus (CMV) endotheliitis.MethodsThis prospective, non-comparative case series study involved six eyes of six patients with endothelial decompensation due to CMV endotheliitis who underwent DSAEK, followed by a continuous, four to six times daily, topical administration of 0.5% GCV. Patient demographics, clinical history, and preoperative and postoperative examination (including any recurrence of CMV endotheliitis post-DSAEK), best corrected visual acuity (BCVA), intraocular pressure (IOP), graft survival rate and endothelial cell density (ECD) were examined.ResultsNo recurrence of CMV endotheliitis was detected post-DSAEK. The mean follow-up period was 40 months (range, 12–60 months). The mean preoperative BCVA was 1.52±0.68 LogMAR (range, 0.52–2.40 LogMAR), yet it had significantly improved to 0.15±0.16 LogMAR (range: −0.08 to 0.30 LogMAR) by 1 year postoperative (P<0.01). In all patients, IOP was well controlled (10–20 mm Hg) postsurgery. The mean preoperative donor ECD was 2692±177 cells/mm2, and the mean postoperative ECD was 1974, 1771 and 1174 cells/mm2 for the ECD loss of 26%, 33% and 54% at 6, 12 and 36 months, respectively. No adverse effects were observed associated with the long-term topical administration of GCV.ConclusionThe continuous topical application of 0.5% GCV was found to be effective for preventing the recurrence of CMV endotheliitis, and it provided the optimal mid-term clinical outcomes post-DSAEK in patients with CMV endotheliitis.Trial registration numberUMIN000026746

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41

Kate, Anahita, and Sayan Basu. "Case Report: Primary graft failure due to a reversed lenticule in Descemet Stripping Automated Endothelial Keratoplasty." F1000Research 11 (January 6, 2023): 1105. http://dx.doi.org/10.12688/f1000research.123313.2.

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Introduction and importance: This report details the clinical features and management in a case of Descemet stripping automated endothelial keratoplasty (DSAEK) which had primary graft failure (PGF) due to an inverted yet attached lenticule. Presentation of case: A 66-year-old gentleman had poor visual recovery in the right eye after undergoing cataract surgery 12 years prior to presentation. The visual acuity was counting fingers and examination revealed endothelial decompensation. The patient underwent a DSAEK and postoperatively had a well attached lenticule. However, the cornea was edematous three weeks after the surgery and optical coherence tomography (OCT) revealed a reversed lenticule. The patient underwent a repeat DSAEK and had an uneventful postoperative course. The visual acuity was 20/40 after 7 months with a clear cornea and a well attached graft. Discussion: PGF is a rare complication following DSAEK which occurs due to poor endothelial function of the donor graft. Insertion of a reversed lenticule may get overlooked as a cause of PGF unless the graft edge profile is examined on an OCT scan. The graft in the current case was well attached despite its inverted position suggesting that graft adherence is perhaps not a function of the corneal endothelial pumps in isolation and may be driven by factors such as the intraocular pressure. Conclusion: A reversed DSAEK lenticule may have normal adherence to the host stroma and must be considered in cases with PGF. OCT of the graft edge is required for diagnosis before performing a repeat keratoplasty.

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42

Li, Saiqing, Zihao Liu, Binjia Sun, et al. "Clinical Outcomes of the Intraocular Lens Injector and Busin Glide for Descemet Stripping Automated Endothelial Keratoplasty in Patients with Iridocorneal Endothelial Syndrome." Journal of Clinical Medicine 12, no. 5 (2023): 1856. http://dx.doi.org/10.3390/jcm12051856.

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Purpose: To report the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) performed in iridocorneal endothelial (ICE) syndrome patients using the intraocular lens injector (injector), in comparison with those using the Busin glide. Methods: In this retrospective, interventional comparative study, we evaluated the outcomes of DSAEK performed using the injector (n = 12) or the Busin glide (n = 12) for patients with ICE syndrome. Their graft position and postoperative complications were recorded. Their best-corrected visual acuity (BCVA) and endothelial cell loss (ECL) were monitored over a 12-month follow-up period. Results: DSAEK was conducted successfully in the 24 cases. The BCVA improved from the preoperative 0.99 ± 0.61 to 0.36 ± 0.35 at 12 months after operation (p < 0.001), with no significant difference between the two groups (the injector group and the Busin group) (p = 0.933). ECL at 1 month after DSAEK was 21.80 ± 15.01% in the injector group, which was significantly lower than 33.69 ± 9.75% of the Busin group (p = 0.031). No surgery-related complications were observed in the 24 cases intraoperatively or postoperatively except that one case suffered from postoperative graft dislocation, without statistical difference between the two groups. Conclusions: At 1 month after surgery, the use of graft injector for delivering DSAEK-based endothelial graft may cause significantly less endothelial cell damage than the pull-through technique used in the application of Busin glide. The injector allows safe endothelial graft delivery without the need of anterior chamber irrigation, which increases the ratio of successful graft attachment.

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NUIJTS, R., MM DICKMAN, FJHM VAN DEN BIGGELAAR, et al. "Ultrathin DSAEK vs. Conventional DSAEK: Results from a Dutch multicentre randomised clinical trial." Acta Ophthalmologica 92 (August 20, 2014): 0. http://dx.doi.org/10.1111/j.1755-3768.2014.4733.x.

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Ahmed, Mahmoud, Mohammad Ahmad, Nardine Menassa, Vito Romano, and Stephen B. Kaye. "Glaucoma Valve Repositioning During DSAEK." Cornea 41, no. 5 (2021): 658–59. http://dx.doi.org/10.1097/ico.0000000000002938.

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45

Kubal, Aarup, and Elizabeth A. Davis. "The DSAEK Big Bubble Technique." Techniques in Ophthalmology 8, no. 2 (2010): 43–47. http://dx.doi.org/10.1097/ito.0b013e3181e91109.

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Kubal, Aarup, and Elizabeth A. Davis. "The DSAEK Big Bubble Technique." Techniques in Ophthalmology 9, no. 4 (2011): 122–26. http://dx.doi.org/10.1097/ito.0b013e318242c4b6.

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47

Pouyeh, Bozorgmehr, William Feuer, Sonia H. Yoo, Wei Shi, and Leejee H. Suh. "Refractive Stability after Phaco-DSAEK." Ophthalmology 119, no. 10 (2012): 2190–2190. http://dx.doi.org/10.1016/j.ophtha.2012.05.042.

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Busin, M. "Ultrathin DSAEK: The Present Status." Acta Ophthalmologica 93 (September 23, 2015): n/a. http://dx.doi.org/10.1111/j.1755-3768.2015.0073.

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Beketova, Tatyana, Margaret Pfeiffer, Alice Chuang, and Gene Kim. "Outcomes of Resident-Performed Descemet's Stripping Automated Endothelial Keratoplasty." Journal of Academic Ophthalmology 09, no. 01 (2017): e26-e31. http://dx.doi.org/10.1055/s-0037-1609035.

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Purpose This article aimed to evaluate outcomes of resident-performed Descemet's stripping automated endothelial keratoplasty (DSAEK). Methods This is a case series of patients who underwent DSAEK performed by PGY-4 ophthalmology residents at Lyndon B. Johnson Hospital from January 2013 to August 2016 staffed by a fellowship-trained cornea specialist. Patients with less than 1 month of follow-up were excluded. Demographics, baseline ocular characteristics, and intraoperative data were recorded. Vision and graft status were recorded at 1 week, 1 month, 3 months, and the last follow-up visits. Surgical failure was defined as graft detachment within 1 week of surgery and/or primary graft failure within 3 months of surgery. Results Eighteen eyes of 18 patients who followed up for 14.9 months (±12.9) were included. Mean age of patients was 60.9 years (±13.2). Indications for DSAEK included pseudophakic bullous keratopathy (10), Fuchs endothelial dystrophy (4), and other causes of endothelial dysfunction (4). Eleven (61%) eyes had prior ocular surgery, and 7 (39%) had prior glaucoma surgery. There were no postoperative graft detachments and two (11%) primary graft failures. There was one primary graft failure in a glaucoma patient. Of the 16 graft successes, logMAR visual acuity improved by 0.46 logMAR (±0.73) from baseline. Conclusion With appropriate staffing by an experienced cornea surgeon, DSAEK with residents as the primary surgeons is a safe and effective procedure with reasonably good outcomes.

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Kobayashi, Akira, Hideaki Yokogawa, Natsuko Mori, Tsubasa Nishino, and Kazuhisa Sugiyama. "Clinical Evaluation of the NS Endo-Inserter, a Novel Donor Inserter for Descemet’s Stripping Automated Endothelial Keratoplasty." Case Reports in Ophthalmology 10, no. 3 (2019): 357–64. http://dx.doi.org/10.1159/000503441.

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Purpose: This study investigated the clinical outcomes achieved with a newly developed donor inserter (NS Endo-Inserter [NSI], HOYA Co., Ltd., Tokyo, Japan) for Descemet’s stripping automated endothelial keratoplasty (DSAEK) in Japanese eyes with bullous keratopathy secondary to argon laser iridotomy (BK-ALI). The NSI device utilizes pressure flow to push the DSAEK donor tissue into the anterior chamber. Methods: Six eyes of 6 patients (1 male, 5 females; mean age, 78.5 years) with BK-ALI were enrolled. Donor tissue was pushed into the anterior chamber using the NSI. Intraoperative complications, graft dislocation, and iatrogenic primary graft failure were recorded for all eyes. Six-month postoperative central donor endothelial cell densities (ECD) were measured prospectively and compared with preoperative values, along with 6-month best corrected visual acuity (BCVA). Results: In all cases, donor loading onto the NSI spatula and donor insertion into the anterior chamber using the NSI was smooth and successful; no intraoperative complications were noted. There were no cases of graft dislocation or IPGF. Postoperative ECD was 2,187.2 cells/mm2 (mean loss, 14.8%) and mean BCVA increased from 0.27 decimal to 0.8 at 6 months. Conclusion: In this small preliminary case series, clinical outcomes for patients with BK-ALI undergoing DSAEK using the NSI were comparable or better than those achieved with conventional DSAEK insertion techniques.

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