Results of Descemet's Stripping with Endothelial Keratoplasty (DSEK) in Patients with Bullous Keratopathy after Cataract Surgery

To evaluate the anatomical and visual outcomes of Descemet`s stripping with endothelial keratoplasty (DSEK) in patients with bullous keratopathy after cataract surgery. The study was performed on 20 eyes of 20 patients (13 male, 7 female) with bullous keratopathy (pseudophakic=15, aphakic=5). Donor lenticule was prepared using a microkeratome (n=12) or manual dissection (n=8). Patients were excluded in case of extensive corneal scarring and/or vascularization. DSEK surgery was performed by removal of recipient endothelium and Descemet`s membrane, and replacement by the donor lenticule. Patients were followed at least for 6 months. Mean age at surgery was 64.66.7 years and mean follow up was 7.32.1 months. At final follow up 15 grafts were clear. Failure was seen in 5 cases. Visual acuity LogMAR was 1.960.38 before and 0.520.09 after the procedure (P<0.0001). Mean topographic keratometry was 46.02.9 D before surgery which reached 44.41.7 D postoperatively (P=0.219). Preoperative astigmatism was 2.51.7 D which decreased to 1.12.3 D at final follow up (P=0.229). Mean pre- and postoperative surface regularity index (SRI) were 1.470.60 and 0.430.17, respectively (P=0.006). No case of endothelial rejection was observed. DSEK surgery is an effective treatment modality in cases of bullous keratopathy after cataract surgery with acceptable anatomical and visual outcomes.