Early Results of Small-Incision Descemet's Stripping and Automated Endothelial Keratoplasty

Descemet's stripping and automated endothelial keratoplasty uses a mechanical microkeratome to harvest the donor corneal lenticule and mechanical stripping of the diseased host endothelium and Descemet's membrane. Despite a smooth graft-host interface, only 2 patients in the series achieved ≥20/25 vision. The average visual results were comparable to vision after deep lamellar endothelial keratoplasty. Although patients experienced excellent postoperative acuity with minimally induced surgical astigmatism, nearly one third of the donor lenticules needed to be either repositioned or replaced. Nevertheless, DSAEK offers significant advantages over standard penetrating keratoplasty for patients with Fuchs' dystrophy in pseudophakic bullous keratopathy.