title: Non-Descemet Stripping Automated Endothelial Keratoplasty for Bullous Keratopathy in Buphthalmic Eye.
abstract: OBJECTIVE
  To report the 2-year follow-up findings in a patient with buphthalmic bullous keratopathy (BK) who was successfully treated with non-Descemet stripping automated endothelial keratoplasty (nDSAEK).
  
  
  METHODS
  A 39-year-old man had an endothelial graft of 8.0 mm diameter placed uneventfully using the nDSAEK method for phakic BK with buphthalmos of the left eye. He had had a penetrating keratoplasty in the right eye due to aphakic BK 5 years earlier, which, however, resulted in the invasion of blood vessels and graft failure. Since the left eye was phakic, Descemetorhexis was not performed because the instruments might touch the crystalline lens. The best-corrected visual acuity (BCVA), intraocular pressure (IOP), and endothelial cell density (ECD) were determined at 2 weeks, and at 1, 3, 6, 12, 18 and 24 months after nDSAEK.
  
  
  RESULTS
  Twenty-four months after nDSAEK, his left cornea and lens remained clear, and the decimal BCVA was 0.8. However, the ECD of the graft had decreased from 2,274 cells/mm(2) before nDSAEK to 539 cells/mm(2) 24 months after the surgery, and the rate of decrease appeared to be slightly faster than that of former reports. An IOP of $1003e;30 mm Hg was recorded at around 2 months after the surgery, but was well controlled by tapering the topical steroids and the addition of topical brinzolamide and latanoprost.
  
  
  CONCLUSIONS
  Our findings show that nDSAEK can be successfully used to treat buphthalmic BK. We recommend that nDSAEK be considered especially in phakic eyes with a smooth posterior surface around the pupillary area.
authors.affiliation: Department of Ophthalmology, Ban Buntane Hotokukai Hospital, School of Medicine, Fujita Health University, Nagoya, Japan; Matsuura Eye Clinic, Ichinomiya, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Hirano
authors.affiliation: Matsuura Eye Clinic, Ichinomiya, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Kachi
authors.affiliation: Matsuura Eye Clinic, Ichinomiya, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Matsuura
authors.affiliation: Matsuura Eye Clinic, Ichinomiya, Japan; Department of Ophthalmology, Gifu University School of Medicine, Gifu, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Kawase
keywords: Bullous keratopathy; Buphthalmos; Haab striae; Non-Descemet stripping endothelial keratoplasty