Descemet stripping endothelial keratoplasty for the treatment of combined fuchs corneal endothelial dystrophy and keratoconus.
OBJECTIVE
To report the first case series of patients with Fuchs corneal endothelial dystrophy (FCD) and keratoconus (KCN) who underwent Descemet stripping endothelial keratoplasty (DSEK).


METHODS
This is a retrospective case series of 6 eyes of 4 patients with combined FCD and KCN who underwent DSEK at 3 different centers. Clinical information collected included corneal topography measurements, central corneal thickness, and endothelial cell count. Visual outcomes and change in keratometric measurements were evaluated.


RESULTS
The follow-up for patients ranged from 10 to 72 months. The best-corrected visual acuity was 20/40 or better in all 6 eyes. The mean keratometric measurements decreased in all cases (range of 0.5-5.8 diopters); however, topography still demonstrated an inferior steepening in each case.


CONCLUSIONS
Patients with FCD and KCN have been previously reported as being managed with penetrating keratoplasty. We present 6 eyes of 4 patients who were managed with DSEK for the FCD. Topographically, the characteristic inferior steepening of KCN did not change; however, all patients with DSEK had flatter postoperative keratometric measurements with improved visual acuity. If a DSEK is performed for FCD before apical corneal scarring from KCN, a good visual outcome may be achieved.
*Department of Ophthalmology, Loyola University Medical Center, Maywood, IL; †Department of Ophthalmology, North Shore Long Island Jewish Health System, Bronx, NY; ‡Albert Einstein College of Medicine, Bronx, NY; §Cornea Service, Wills Eye Institute, Philadelphia, PA; and ¶Department of Ophthalmology, Northwestern Memorial Hospital, Chicago, IL.
Samir
S
Vira
Usiwoma
U
Abugo
Carolyn Y
CY
Shih
Ira J
IJ
Udell
Brian
B
Sperling
Sadeer B
SB
Hannush
Surendra
S
Basti
Charles S
CS
Bouchard
D000328:Adult; D000368:Aged; D019781:Corneal Topography; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications / Q000601:surgery*; D006801:Humans; D007640:Keratoconus / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014792:Visual Acuity