title: Two-year outcomes of an initial series of DSAEK cases in normal and abnormal eyes at an inner-city university practice.
abstract: OBJECTIVE
  To report our initial series of Descemet stripping automated endothelial keratoplasty (DSAEK) patients with 2 years of follow-up and to compare the complications and outcomes between normal and abnormal eyes.
  
  
  METHODS
  Records of all patients who underwent DSAEK between April 2007 and April 2009 were reviewed. Eyes were categorized as "normal" or "abnormal" for comparison. Two risk factors, anterior chamber compromise and glaucoma tube/bleb, were analyzed for association with tissue detachment.
  
  
  RESULTS
  Thirteen DSAEKs were performed on 13 "normal" eyes, and 18 DSAEKs were performed on 15 "abnormal" eyes. The lenticule detachment rates were 15.4% in the normal group and 41.2% in the abnormal group (P = 0.13). The difference in endothelial cell loss was not significant until 1.5 years postoperatively in favor of the abnormal group (P = 0.024). The mean starting vision was 20/115 for the normal group and 20/322 for the abnormal group (P = 0.06). At 2 years, the mean visual acuity was 20/47 for the normal group and 20/34 for the abnormal group (P = 0.44). Risk factor analyses indicated that glaucoma tubes/blebs were not related to lenticule detachment (P = 0.45), whereas anterior chamber compromise was related to lenticule detachment (P = 0.031).
  
  
  CONCLUSIONS
  Complication rates for abnormal eyes are higher than those for normal eyes, and risk factor analyses suggest that marked anterior chamber compromise is related to lenticule detachment. However, if DSAEK is successful for these compromised eyes, the visual outcomes compare favorably with normal eyes through 2 years of follow-up.
authors.affiliation: Doheny Eye Institute, Department of Ophthalmology, USC Keck School of Medicine, Los Angeles, CA 90033, USA. hhsu@doheny.org
authors.forename: Hugo Y
authors.initials: HY
authors.lastname: Hsu
authors.forename: Sean L
authors.initials: SL
authors.lastname: Edelstein
mesh_terms: D000368:Aged; D000867:Anterior Chamber / Q000473:pathology; D002452:Cell Count; D015715:Corneal Edema / Q000150:complications; D055954:Corneal Endothelial Cell Loss / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity