title: Results of Descemet Stripping Automated Endothelial Keratoplasty for the Treatment of Late Corneal Decompensation Secondary to Obstetrical Forceps Trauma.
abstract: OBJECTIVE
  To describe the clinical outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in a series of patients affected by progressive endothelial cell loss leading to corneal decompensation with Descemet membrane (DM) breaks caused by obstetrical forceps trauma.
  
  
  METHODS
  Seven amblyopic eyes of 7 patients affected by unilateral visual loss due to increasing corneal edema were included in the study. In all eyes, slit-lamp examination revealed typical DM breaks and diffuse corneal edema: these findings were compatible with a history of obstetrical forceps-assisted delivery. DSAEK was performed in all cases (in 3 eyes combined with phacoemulsification and intraocular lens implantation); visual acuity, refraction, corneal topography, and endothelial cell density were recorded preoperatively and 1 year after surgery.
  
  
  RESULTS
  Visual acuity improved in all cases by at least 2 Snellen lines; topographic astigmatism lower than 2.5 diopters was associated with better visual recovery. No intraoperative or postoperative complications were reported, and the corneas remained clear throughout the follow-up.
  
  
  CONCLUSIONS
  In eyes with endothelial decompensation secondary to DM breaks caused at birth by forceps injury, DSAEK can be performed uneventfully and restore cornea clarity. However, visual recovery is limited by the preexistent amblyopia, usually resulting from anisometropia and/or high-degree unilateral astigmatism. The results obtained in our patients suggest that low-degree astigmatism may be associated with better visual outcomes.
authors.affiliation: *Department of Ophthalmology, University of Magna Graecia, Catanzaro, Italy; †Department of Ophthalmology, Ospedale Privato Villa Igea, Forlì, Italy; and ‡Istituto internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scorcia
authors.forename: Rocco
authors.initials: R
authors.lastname: Pietropaolo
authors.forename: Adriano
authors.initials: A
authors.lastname: Carnevali
authors.forename: Valentina
authors.initials: V
authors.lastname: De Luca
authors.forename: Andrea
authors.initials: A
authors.lastname: Lucisano
authors.forename: Massimo
authors.initials: M
authors.lastname: Busin
mesh_terms: D000328:Adult; D000368:Aged; D002452:Cell Count; D015715:Corneal Edema / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D065306:Corneal Injuries / Q000150:complications* / Q000209:etiology; D019781:Corneal Topography; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000166:cytology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009772:Obstetrical Forceps / Q000009:adverse effects*; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology