Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) Outcomes in High-Risk Patients [post]

Blanca Elizabeth Martínez-Báez, Abraham Alejandro Medina-Andrade, Gonzalo García de Oteyza, Everardo Hernández Quintela, Ana Mercedes Garcia-Albisua, Valeria Sánchez Huerta, Guillermo de Wit Carter
2021 unpublished
Purpose To evaluate the results, survival rates, and proportion of complications related to Descemet Stripping Automated Endothelial Keratoplasty in high-risk patients. Methods Thirty-three patients (thirty-four eyes) who underwent DSAEK surgery between 2015 and 2019 were included in this retrospective, observational study. All participants were considered high-risk patients with a history of previous glaucoma surgery with glaucoma drainage device, previous graft failure, previous anterior
more » ... vious anterior chamber intraocular lens, or glaucoma with an indication of corneal surgery. Results After 7.1 months of follow-up (range from 1 to 35.9 months), seventeen eyes (50%) had graft failure. Among those, eight eyes (47%) belonged to the previous graft failure group, and seven eyes (41%) had a glaucoma drainage device in the anterior chamber. Although best-corrected visual acuity (BCVA) did not improve significantly postoperatively (p = 0.112), twelve eyes improved their visual acuity, and fifteen eyes remained unchanged. The percentage of eyes with BCVA of 20/40 or better improved from 11% preoperatively to 26% postoperatively. The most common surgical complication was lamellae dislocation, occurring in six eyes. Conclusions Adverse outcomes are highly common in high-risk patients who receive a DSAEK, especially in those patients for whom a graft previously failed or with a glaucoma drainage device. The most common complication was graft detachment, with a rate similar to other reports in non-high-risk patients. In our series, previous graft failure is a higher risk factor than a GDD.
doi:10.21203/ fatcat:aooxi32pdveajco6gdbszbilyq