Endothelial cell damage in descemet stripping automated endothelial keratoplasty with the underfold technique: 6- and 12-month results.

Purpose: To evaluate the endothelial cell loss at 6 and 12 months after Descemet stripping automated endothelial keratoplasty (DSAEK) using a modified 40/60 underfolding technique and to compare this to the literature on other commonly used implantation techniques, such as the conventional 60/40-fold, gliding, and hitch suture techniques.

Methods: Endothelial cell density was measured prospectively, and cell loss was calculated at 6 and 12 months after endothelial keratoplasty using a recently described underfolding implantation technique.

Results: In this study, 305 eyes undergoing DSAEK were evaluated.

Descemet's stripping automated endothelial keratoplasty: innovations in surgical technique.

Purpose Of Review: Endothelial transplantation has supplanted penetrating keratoplasty as the procedure of choice for endothelial dysfunction. Its recent widespread acceptance has encouraged innovation in the field in an attempt to offer faster, better surgery to a broader number of patients while reducing surgical risk. This review focuses on the best studied and the most widely used form; Descemet's stripping automated endothelial keratoplasty (DSAEK).

Descemet stripping automated endothelial keratoplasty in eyes with previous trabeculectomy and tube shunt procedures: intraoperative and early postoperative complications.

Purpose: To evaluate the intraoperative and early postoperative outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with previous glaucoma filtering surgeries.

Methods: A retrospective review of all DSAEK surgeries performed at one center comparing complications of DSAEK in eyes with previous glaucoma filtering procedures (study eyes) with a time-matched group of all other DSAEK cases (control eyes).

Results: There were 28 study eyes, 19 with previous trabeculectomies and 9 with previous glaucoma drainage devices (GDDs) and 431 control eyes.

Complications and clinical outcomes of descemet stripping automated endothelial keratoplasty with intraocular lens exchange.

Purpose: To evaluate complications and clinical outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) with intraocular lens (IOL) exchange compared with DSAEK alone.

Design: Retrospective, interventional case series.

Methods: DSAEK was performed in 19 eyes in which the anterior chamber IOL was exchanged for a posterior chamber IOL (study group) and in 188 eyes in which the posterior chamber IOL was left in place (comparison group).

Endothelial keratoplasty: endothelial cell loss after deep lamellar endothelial keratoplasty with retention of an open-loop anterior chamber intraocular lens.

Purpose: To prospectively assess the impact of a retained open-loop anterior chamber intraocular lens (ACIOLs) on endothelial cell loss after deep lamellar endothelial keratoplasty (DLEK).

Methods: Prospectively gathered central endothelial cell densities of eyes with open-loop ACIOLs after DLEK were examined at 6 months, 1 year, and 2 years.

Results: Nine eyes with an open-loop ACIOL were examined.

Descemet's stripping automated endothelial keratoplasty (DSAEK) using corneal donor tissue not acceptable for use in penetrating keratoplasty as a result of anterior stromal scars, pterygia, and previous corneal refractive surgical procedures.

Purpose: The purpose of this study was to evaluate outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) using anterior stromal flawed (ASF) donor corneas that were unsuitable for use in full-thickness penetrating keratoplasty as a result of stromal scars, pterygia, or previous corneal refractive surgery and to compare results with DSAEK using standard tissue.

Methods: We conducted a review of our initial 42 (19 with 6-month follow up) consecutive DSAEK surgeries using ASF tissue compared with 357 (199 with 6-month follow up) time-matched controls using standard tissue. Intraoperative and perioperative complications, including dislocations and primary graft failures, were compared.

Retention of host embryonic descemet membrane in endothelial keratoplasty.

Objective: To describe a case of retained host embryonic Descemet membrane (DM) after Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods: Review of clinical findings in a case of DSAEK with retention of host embryonic DM.

Results: A geographic and patchy haze in the interface involving the visual axis was noted postoperatively as soon as 1 week after DSAEK surgery.

Endothelial keratoplasty: vision, endothelial survival, and complications in a comparative case series of fellows vs attending surgeons.

Purpose: To compare a 6-month postoperative vision, endothelial cell loss, and immediate postoperative complications in Descemet stripping automated endothelial keratoplasty (DSAEK) cases performed by an experienced corneal surgeon and his inexperienced fellows using an established technique.

Design: Retrospective analysis of prospectively gathered data in 327 consecutive DSAEK cases.

Methods: DSAEK cases performed by fellows vs attending surgeons during a concurrent period were compared for 6-month postoperative best spectacle-corrected visual acuity (BSCVA), endothelial cell loss, and immediate postoperative complications.

Endothelial keratoplasty for Fuchs' dystrophy with cataract: complications and clinical results with the new triple procedure.

Purpose: To report the immediate postoperative complications and the 6- and 12-month clinical results in a large series of cases undergoing the new triple-procedure Descemet's stripping automated endothelial keratoplasty (DSAEK) and concurrent cataract surgery.

Design: Prospective, noncomparative, interventional case series.

Participants: Three hundred fifteen eyes of 233 patients with Fuchs' corneal dystrophy were evaluated for the complications of dislocation and iatrogenic primary graft failure (IPGF).

Epithelial downgrowth after Descemet-stripping automated endothelial keratoplasty.

A 66-year-old man presented with decreased vision and corneal edema after 2 failed Descemet-stripping automated endothelial keratoplasty (DSAEK) graft procedures in the left eye. An uneventful third DSAEK procedure combined with anterior vitrectomy through the previous limbal wound was performed. Postoperative recovery was uneventful.

Endothelial keratoplasty: the influence of insertion techniques and incision size on donor endothelial survival.

Purpose: To determine the acute endothelial cell damage from trephination and tissue insertion in endothelial keratoplasty (EK) surgery. The influence of insertion technique (forceps insertion vs "pull-through" insertion) of donor tissue and incision size (3 vs 5 mm length) was assessed.

Methods: Forty precut 8.

Precut tissue for Descemet's stripping automated endothelial keratoplasty: vision, astigmatism, and endothelial survival.

Purpose: To report 6 and 12 month results using precut tissue for Descemet's stripping automated endothelial keratoplasty (DSAEK) and correlate donor characteristics with clinical outcomes.

Design: Prospective, noncomparative, interventional case series.

Participants: We reviewed 100 donor corneas precut for 100 eyes of 90 DSAEK patients.

Endothelial keratoplasty: the influence of preoperative donor endothelial cell densities on dislocation, primary graft failure, and 1-year cell counts.

Purpose: The purpose of this study was to determine if an association exists between preoperative donor central endothelial cell density (ECD) and the complications of donor dislocation, iatrogenic primary graft failure (IPGF), and endothelial survival at 1 year after endothelial keratoplasty (EK) surgery.

Methods: A prospective, nonrandomized, interventional case study was conducted evaluating 629 consecutive EK procedures. The preoperative donor ECD was recorded for each case.

Transscleral sulcus fixation of a small-diameter iris-diaphragm intraocular lens in combined penetrating keratoplasty and cataract extraction for correction of traumatic cataract, aniridia, and corneal scarring.

We present the case of a 36-year-old Hispanic man who presented with photophobia and hand motion acuity from a lacerated cornea. Primary repair had been performed 13 years earlier. In addition to a densely scarred cornea and a fibrotic, partially resorbed cataract, more than 300 degrees of iris loss was noted.

Descemet-stripping automated endothelial keratoplasty: insertion using a novel 40/60 underfold technique for preservation of donor endothelium.

Purpose: To describe a technique for insertion of an asymmetrically folded donor graft to minimize endothelial damage during Descemet-stripping automated endothelial keratoplasty.

Methods: The tissue is folded in a 40/60 underfold rather than the commonly used 60/40 overfold. It is then grasped with the insertion forceps by using a prone hand position.

An easy and inexpensive method for quantitative analysis of endothelial damage by using vital dye staining and Adobe Photoshop software.

Purpose: We developed a simple, practical, and inexpensive technique to analyze areas of endothelial cell loss and/or damage over the entire corneal area after vital dye staining by using a readily available, off-the-shelf, consumer software program, Adobe Photoshop. The purpose of this article is to convey a method of quantifying areas of cell loss and/or damage.

Methods: Descemet-stripping automated endothelial keratoplasty corneal transplant surgery was performed by using 5 precut corneas on a human cadaver eye.

Descemet-stripping automated endothelial keratoplasty: six-month results in a prospective study of 100 eyes.

Purpose: To report 6-month results in a large, prospective study of Descemet-stripping automated endothelial keratoplasty (DSAEK).

Methods: A 5-mm scleral-limbal tunnel approach was created for placement of an automated microkeratome-prepared 8.0-mm endothelial graft after DSAEK in 150 consecutive cases between September 2005 and October 2006.

Descemet-stripping endothelial keratoplasty: improvement in vision following replacement of a healthy endothelial graft.

We describe a case of endothelial graft exchange in a patient who had inadequate vision without a clinically identifiable cause following Descemet-stripping endothelial keratoplasty (DSEK). The initial DSEK was performed with a hand-dissected donor, and the replacement graft was prepared with an automated microkeratome. The best spectacle-corrected visual acuity (BSCVA) improved from 20/50 before replacement to 20/25 after replacement.

Endothelial keratoplasty: improvement of vision after healthy donor tissue exchange.

Objective: To report 3 cases of graft exchange by using a microkeratome-prepared donor tissue in place of a manually prepared donor tissue for inadequate postoperative visual acuity after deep lamellar endothelial keratoplasty and to discuss possible etiologies.

Methods: Prospective, observational case series. The patients were 3 consecutive patients who underwent endothelial graft replacement for unsatisfactory vision after initial deep lamellar endothelial keratoplasty.

Precut tissue in Descemet's stripping automated endothelial keratoplasty donor characteristics and early postoperative complications.

Purpose: To describe donor characteristics of eye bank-prepared precut tissue used in Descemet's stripping automated endothelial keratoplasty (DSAEK) and report any increase in immediate postoperative complications associated with its use.

Design: Prospective, noncomparative, interventional case series.

Participants: One hundred donor corneas deemed appropriate for transplant and 100 eyes undergoing DSAEK for endothelial dysfunction.

Endothelial cell loss after Descemet's stripping endothelial keratoplasty in a large prospective series.

Purpose: To report the donor endothelial cell loss in the first year after Descemet's stripping endothelial keratoplasty (DSEK) for the treatment of endothelial dysfunction.

Design: Prospective noncomparative interventional case series.

Participants: Eighty eyes of 78 patients with corneal edema.