title: Clinical results of non-Descemet stripping endothelial keratoplasty.
abstract: OBJECTIVE
  To investigate the impact of non-Descemet stripping endothelial keratoplasty (non-DSEK) on graft rejection rate, and its overall procedural effectiveness in patients.
  
  
  METHODS
  Non-DSEK was performed on 65 eyes of 64 patients, and the procedural outcomes, including rejection episodes, failure and dislocation of the grafts, best corrected visual acuity (BCVA), endothelial cell density (ECD), and other complications, were analyzed retrospectively.
  
  
  RESULTS
  Of the 65 eyes, 63 recovered from bullous keratopathy with a clear cornea. The mean follow-up time was 26.4mo (range, 6-84mo). The mean BCVA improved from 1.70 logMAR preoperatively to 0.54 logMAR at 3mo, 0.46 logMAR at 6mo, and 0.37 logMAR at 1y after surgery. The postoperative donor ECD of the 25 patients who successfully underwent specular microscopic examination was 1918±534 cells/mm2(range, 637 to 3056 cells/mm2), and the mean endothelial cell loss was 41.9% at 24mo postoperatively. One eye developed secondary glaucoma and required regraftingviapenetrating keratoplasty (PKP). Another eye had postoperative graft failure due to rejection at 26mo. Postoperative graft dislocation occurred in eight eyes. All of the eight dislocated grafts were reattached using air reinjection.
  
  
  CONCLUSIONS
  Immunological graft rejection of the donor graft rarely occurs in non-DSEK. Therefore, non-DSEK is a safe, concise, and effective alternative to restore corneal decompensation when the Descemet membrane is disease-free.
authors.affiliation: Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha 410083, Hunan Province, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha 410083, Hunan Province, China; Department of Ophthalmology, Beijing Aier-Intech Eye Hospital, Beijing 100021, China.
authors.forename: Shao-Wei
authors.initials: SW
authors.lastname: Li
authors.affiliation: Department of Ophthalmology, Shenyang Aier Eye Hospital, Shenyang 110000, Liaoning Province, China.
authors.forename: Tie-Hong
authors.initials: TH
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha 410083, Hunan Province, China.
authors.forename: Jing-Liang
authors.initials: JL
authors.lastname: He
authors.affiliation: Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha 410083, Hunan Province, China.
authors.forename: Yan-Wei
authors.initials: YW
authors.lastname: Kang
authors.affiliation: Department of Ophthalmology, Shenyang Aier Eye Hospital, Shenyang 110000, Liaoning Province, China.
authors.forename: Fang-Qi
authors.initials: FQ
authors.lastname: Lyu
authors.affiliation: Department of Ophthalmology, Shenyang Aier Eye Hospital, Shenyang 110000, Liaoning Province, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Ning
authors.affiliation: Department of Ophthalmology, Beijing Aier-Intech Eye Hospital, Beijing 100021, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
keywords: Descemet membrane; endothelial dysfunction; endothelial keratoplasty; non-Descemet stripping endothelial keratoplasty