title: [Descemet's stripping automated endothelial keratoplasty (DEAEK). Systematic review of clinical-effectiveness and safety].
abstract: OBJECTIVE
  To conduct a systematic review of the efficacy/effectiveness, safety and cost of Descemet's stripping automated endothelial keratoplasty (DSAEK) technique in patients with corneal endothelial failure.
  
  
  METHODS
  Comprehensive literature search conducted in the main biomedical databases from January-May 2012.
  
  
  RESULTS
  Following a critical perusal of the total of 485 abstracts retrieved, 16 case series and one economic evaluation study were included. Corrected distance visual acuity and uncorrected distance visual acuity improved after treatment with DSAEK, attaining values of 0.6 to 0.8 and 0.5 respectively. The degree of post-DSAEK astigmatism was not significant with respect to baseline values. The main complications were graft dislocation-detachment (1.5-23%), primary failure (0-12%) and endothelial rejection (0.8-8.5%).
  
  
  CONCLUSIONS
  In Fuchs' dystrophy and bullous keratopathy, data on the effectiveness of DSAEK indicate post-intervention improvement in uncorrected and corrected distance visual acuity. Astigmatism arising after DSAEK was not significant. The most significant post-DSAEK complications are linked to the viability of the graft, with the most frequent complications being dislocation-detachment and, to a lesser extent, endothelial rejection. The studies that assess DSAEK are case series, and for the most part retrospective. The quality of this type of studies is both low and limited.
authors.affiliation: Consellería de Sanidadem, Dirección Xeral de Innovación e Xestión da Saúde Pública, Axencia de Evaluación de Tecnoloxías Sanitarias de Galicia (avalia-t), Santiago de Compostela, La Coruña, España. Electronic address: avalia-t2@sergas.es.
authors.forename: L
authors.initials: L
authors.lastname: Paz-Valiñas
authors.affiliation: Consellería de Sanidadem, Dirección Xeral de Innovación e Xestión da Saúde Pública, Axencia de Evaluación de Tecnoloxías Sanitarias de Galicia (avalia-t), Santiago de Compostela, La Coruña, España.
authors.forename: R
authors.initials: R
authors.lastname: de la Fuente-Cid
authors.affiliation: Servizo de Oftalmoloxía, Complexo Hospitalario Universitario A Coruña, La Coruña, España.
authors.forename: M V
authors.initials: MV
authors.lastname: de Rojas-Silva
authors.affiliation: Servizo de Oftalmoloxía, Complexo Hospitalario Universitario A Coruña, La Coruña, España.
authors.forename: I
authors.initials: I
authors.lastname: López-Rodríguez
authors.affiliation: Consellería de Sanidadem, Dirección Xeral de Innovación e Xestión da Saúde Pública, Axencia de Evaluación de Tecnoloxías Sanitarias de Galicia (avalia-t), Santiago de Compostela, La Coruña, España.
authors.forename: M
authors.initials: M
authors.lastname: López-García
mesh_terms: D003316:Corneal Diseases / Q000601:surgery*; D003365:Costs and Cost Analysis; D057111:Descemet Stripping Endothelial Keratoplasty / Q000009:adverse effects / Q000191:economics; D006801:Humans; D016896:Treatment Outcome; D014792:Visual Acuity
keywords: DSAEK; Descemet's membrane; Distrofia de Fuchs; Endothelial keratoplasty; Fuchs’ dystrophy; Membrana de Descemet; Queratoplastia endotelial