DSAEK in Buphthalmos

1. Jacqueline Beltz
2. Massimo Busin

Villa Serena Hospital, Forli', Italy

Purpose To report the results of Descemet stripping automated endothelial keratoplasty (DSAEK) performed for patients with endothelial failure in the setting of congenital glaucoma.
Methods All patients presenting with corneal endothelial failure and buphthalmos between 1/1/07 and 30/9/10 were enrolled in our study.

Results The study consisted of 9 transplants in 8 eyes of 7 patients. Detachment requiring re-bubble on day 1 occurred in 2 of the 8 eyes. One patient required repeat DSAEK for failure of attachment, and no further complications were identified. Corneal oedema resolved in all of the cases in which attachment was achieved. All patients reported symptomatic improvement. Visual acuity improved to > 20/50 in 3 eyes, and did not improve in 5 eyes due to co-morbidities including amblyopia and advanced glaucoma. Mean endothelial cell loss (for 5 eyes for which data was available) was 42.4% at 9.6 months. Glaucoma control did not worsen in any of the cases.

Conclusions DSAEK may be performed safely and effectively for cases with buphthalmos and corneal endothelial decompensation. The surgery is technically more challenging, however, results approach those seen with DSAEK for other causes of endothelial failure.