Visually significant and nonsignificant complications arising from Descemet stripping automated endothelial keratoplasty.
OBJECTIVE
To examine the complications encountered after Descemet stripping automated endothelial keratoplasty (DSAEK) at one institution.


METHODS
Retrospective case review.


METHODS
The first 126 consecutive DSAEKs done at the New York Eye and Ear Infirmary from March 1, 2006 to March 1, 2008 were reviewed. A total of 126 eyes of 113 patients underwent DSAEK. All cases were included regardless of outcome. All complications intraoperatively and postoperatively were recorded.


RESULTS
Graft detachment was the most common complication, occurring in 22 eyes (17.5%); 17 of these (77%) were successfully repositioned. Idiopathic graft failure occurred in 15 eyes (6%). Other visually significant complications included graft rejection (2 eyes), choroidal effusion (2 eyes), epithelial ingrowth (2 eyes), endophthalmitis (1 eye), pupillary block (1 eye), and suture abscess (1 eye). Twenty-four eyes had non-visually significant complications including decentered lenticles, interface fibers, partial peripheral detachments, retained Descemet membrane, and eccentric trephination.


CONCLUSIONS
While DSAEK is a viable alternative to penetrating keratoplasty, serious complications may still occur postoperatively. While certain rare complications like endophthalmitis, epithelial ingrowth, and suture abscess may affect vision, more common complications such as decentered lenticles and partial peripheral detachments are less likely to affect visual outcome.
Shih
Carolyn Y
CY
Department of Ophthalmology, The New York Eye & Ear Infirmary, New York, New York, USA. carolynshih_wu@yahoo.com
Ritterband
David C
DC
Rubino
Shaina
S
Palmiero
Pat-Michael
PM
Jangi
Anisha
A
Liebmann
Jeffrey
J
Ritch
Robert
R
Seedor
John A
JA
D000368:Aged; D003316:Corneal Diseases / Q000601:surgery; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000637:transplantation*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology*; D014792:Visual Acuity