title: Endothelial cell loss and complication rates with combined Descemets stripping endothelial keratoplasty and cataract surgery in a UK centre.
abstract: OBJECTIVE
  To report 6-month, 1- and 2-year endothelial cell loss (ECL), intra- and postoperative complications in a large series of patients undergoing either Descemets stripping endothelial keratoplasty (DSEK) or a combined phacoemulsification and DSEK in a UK centre.
  
  
  METHODS
  Patients undergoing DSEK with or without concurrent cataract surgery were included in this retrospective study. Surgeries were performed between January 2006 and May 2013. Main outcomes included intra- and postoperative complications and percentage ECL.
  
  
  RESULTS
  DSEK was performed in 226 eyes (210 patients). Of these, 141 eyes (126 patients) underwent DSEK alone and 85 eyes (84 patients) underwent DSEK combined with cataract surgery. Excluding complex anterior segment pathology the mean percentage ECL at 6, 12 and 24 months was 40.5±13.4, 45.1±14.6 and 53.1±13.0 in the DSEK group and 40.7±15.4, 42.6±15.3 and 49.6±16.5 in patients undergoing the combined procedure, respectively. There was no significant difference in percentage ECL at 6 or 24 months between the two groups both in complex and routine cases. Intraoperative complications occurred in four patients undergoing DSEK and three undergoing combined procedure. Postoperative complication rates did not reach statistical significance between the groups.
  
  
  CONCLUSIONS
  Mean ECL and complication rates were comparable at 6, 12 and 24 months in routine cases undergoing concurrent DSEK with cataract surgery and those undergoing DSEK. These data support the combined procedure in patients requiring both cataract surgery and endothelial keratoplasty. Further collaboration to report endothelial cell counts from other UK centres should be encouraged.
authors.affiliation: Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Jones
authors.affiliation: Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Fajgenbaum
authors.affiliation: Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: E J
authors.initials: EJ
authors.lastname: Hollick
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D002386:Cataract / Q000150:complications; D002452:Cell Count; D003316:Corneal Diseases / Q000150:complications; D055954:Corneal Endothelial Cell Loss / Q000453:epidemiology* / Q000209:etiology; D057111:Descemet Stripping Endothelial Keratoplasty / Q000009:adverse effects / Q000706:statistics & numerical data*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000009:adverse effects / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D019591:Pseudophakia / Q000209:etiology; D006113:United Kingdom / Q000453:epidemiology