title: Descemet stripping automated endothelial keratoplasty for endothelial decompensation in buphthalmos.
abstract: OBJECTIVE
  To report the results of Descemet stripping automated endothelial keratoplasty (DSAEK) to treat endothelial failure in eyes with buphthalmos.
  
  
  METHODS
  Prospective interventional case series.
  
  
  METHODS
  All buphthalmic eyes with endothelial failure undergoing DSAEK by the same surgeon (M.B.) between March 2007 and January 2012 were included. Outcome measures included best spectacle-corrected visual acuity (BSCVA), refraction, and endothelial cell loss (assessed 6, 12, 24, 36, and 48 months postoperatively). Standardized DSAEK was performed in all cases, with minor modifications in phakic and aphakic eyes. Other outcomes included comparisons to penetrating keratoplasty (PK) published results and comparisons to visual outcomes in DSAEK for other indications.
  
  
  RESULTS
  There were 14 transplants performed in 12 eyes (11 patients). Mean age was 34.9 years (range 15-54 years). The average follow-up was 21.7 ± 13.8 months (range 6-48 months). At last follow-up examination, BSCVA had improved in 11 of 13 cases, with a logMAR average value ± standard deviation of 0.74 ± 0.66 from the preoperative value of 2.07 ± 0.80. Eleven eyes reached Snellen acuity of 20/200 or better, and 5 eyes reached 20/40 or better. Mean endothelial cell loss was 40.5% ± 8.9% (range 23.7%-53.1%). Complications included graft detachment (n = 2), glaucoma progression (n = 1), and late endothelial failure (n = 1). All complications were managed successfully either by repeat DSAEK (n = 2), rebubbling (n = 1), or cyclocryocoagulation (n = 1).
  
  
  CONCLUSIONS
  DSAEK may be performed safely and effectively in buphthalmic eyes, with comparable results to outcomes after PK. Visual outcomes are not substantially different after DSAEK for this indication compared to DSAEK for other indications.
authors.affiliation: Villa Igea Hospital, Department of Ophthalmology, Forlì, Italy; Centre For Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Beltz
authors.affiliation: Villa Igea Hospital, Department of Ophthalmology, Forlì, Italy; Alexandria University, Department of Ophthalmology, Alexandria, Egypt.
authors.forename: Silvana
authors.initials: S
authors.lastname: Madi
authors.affiliation: Villa Igea Hospital, Department of Ophthalmology, Forlì, Italy; Central Regional Hospital, Department of Ophthalmology, Bolzano, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Santorum
authors.affiliation: Villa Igea Hospital, Department of Ophthalmology, Forlì, Italy; University of Magna Graecia, Department of Ophthalmology, Catanzaro, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scorcia
authors.affiliation: Villa Igea Hospital, Department of Ophthalmology, Forlì, Italy. Electronic address: mbusin@yahoo.com.
authors.forename: Massimo
authors.initials: M
authors.lastname: Busin
mesh_terms: D000293:Adolescent; D000328:Adult; D015715:Corneal Edema / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006871:Hydrophthalmos / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult