Outcome of Descemet Stripping Automated Endothelial Keratoplasty in Failed Penetrating Keratoplasty.

PURPOSE: The purpose of this study was to report the outcomes of descemet stripping automated endothelial keratoplasty (DSAEK) surgeries in eyes with failed penetrating keratoplasty (PKP).

METHODS: This was a retrospective, noncomparative, descriptive case series. Patients who underwent DSAEK following PKP from January 2007 to December 2012 were reviewed. Data were collected on best-corrected visual acuity (BCVA) before and 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years following DSAEK. Intra- and post-operative complications, changes in intraocular pressure (IOP) were also documented. Demographics were associated with the visual outcomes.

RESULTS: Fifteen eyes of 15 patients with failed PKP comprised the study group. BCVA improved by 2 or more lines at 6 months after DSAEK in ten (66.6%) eyes. In the five eyes that did not experience an increase in BCVA, four had complications; detached lenticule (2 eyes), rejection (1 eye), and dislocation of the graft (1 eye). One eye had ocular comorbidity causing poor vision. The mean IOP at 12-15 weeks postoperatively was 17.4 ± 6.8 mmHg.

CONCLUSION: DSAEK for failed PKP resulted in improved vision in two-third of cases. Selection of cases for this repeat surgery seems to be a key in successful outcomes.