Deep lamellar endothelial keratoplasty yields long-term safety

Martin Dirisamer, MD, presented the results during the annual meeting of the American Society of Cataract and Refractive Surgery.

Twenty-two patients (11 men, 11 women; age range, 26 to 86 years) were included in this cohort; the average follow-up time was 10 years. DLEK was performed to treat 15 eyes with bullous keratopathy and seven eyes with Fuchs' endothelial dystrophy. The investigators were interested in determining the graft survival, postoperative complications, endothelial cell density, best-corrected visual acuity (BCVA), and topography.

Other complications included three cases of secondary graft failure, with one cornea having progressive decompensation 1 year after DLEK, and two grafts failed 6 years after DLEK. Two eyes had reversible allograft rejection at 18 months and 4 years postoperatively. Steroid-induced glaucoma developed in two eyes.

Graft survival rate

The endothelial cell density decreased to 590 cells/mm² at the 10-year follow-up evaluation.

He also pointed out that in both DLEK and PK the greatest decrease in cells occurs during the first few years after the procedures, and the rate of decrease then stops dropping sharply and finally plateaus.