Intracellular dark spots are associated with endothelial cell loss after Descemet's stripping automated endothelial keratoplasty.

Intracellular dark endothelial spots (IDESs) on specular microscopy developed in 78/122 patients (63.9%) after Descemet stripping automated endothelial keratoplasty (DSAEK). Endothelial cell density (ECD) after DSAEK was significantly smaller in eyes with IDES when compared with those without at all time points (p<0.