Autologous Descemet Stripping Automated Endothelial Keratoplasty to Eliminate Endothelial Rejection in Eyes at High Risk.

Abstract:

PURPOSE:To determine whether autologous Descemet stripping endothelial keratoplasty is technically feasible and whether it eliminates the risk of endothelial rejection in "only eyes" at high risk of immunological rejection. METHODS:This is a prospective observational interventional study from 2016 to 2018 with a 24-month follow-up in a tertiary-level corneal referral center, Forlì, Italy. One 25-year-old woman with failed penetrating keratoplasty after endothelial rejection in the context of chronic panuveitis and a blind fellow eye due to retinal detachment underwent autologous Descemet stripping automated keratoplasty. An endothelial graft was harvested from the fellow eye by performing a hinged, microkeratome-assisted superficial stromal flap, with removal of the central posterior stromal bed. The posterior lamellar graft created was then transplanted into the other eye using a standardized Descemet stripping automated endothelial keratoplasty (DSAEK) technique. Main outcome measures were endothelial rejection, best spectacle-corrected visual acuity, and endothelial cell density. RESULTS:No endothelial rejection was seen during the 2-year follow-up duration. Stable improvement in best spectacle-corrected visual acuity from 0.2 to 0.4 (decimal Snellen) was observed. Endothelial cell density of 1465 (cells/mm) was recorded at the final follow-up. CONCLUSIONS:The use of this repeatable technique to harvest and transplant an autologous DSAEK graft eliminates endothelial rejection in high-risk eyes.

journal_name

Cornea

journal_title

Cornea

authors

Myerscough J,Friehmann A,Bovone C,Busin M

doi

10.1097/ICO.0000000000002184

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

666-668

issue

5

eissn

0277-3740

issn

1536-4798

journal_volume

39

pub_type

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