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Cornea and External Disease

DSAEK More Successful Under These Circumstances

Posted on December 17, 2018

A successful outcome using Descemet stripping automated endothelial keratoplasty (DSAEK) tends to occur when donors are diabetes-free, and when there are no operative complications, according to a randomized trial involving 1,330 eyes. Additionally, long-term postop outcomes seem to be better in recipients with Fuchs dystrophy vs those with pseudophakic/aphakic corneal edema (PACE). 

Participants were a median 70 years of age, and underwent DSAEK for Fuchs corneal dystrophy (94%) or PACE (6%). They were randomized to receive a donor cornea with preservation time of either 0 to 7 days (n=675) or 8 to 4 days (n=655). Investigators looked at graft success at 3 years. Among the results: 

  • 94% of grafts were still clear and considered successful at 3 years. 
  • After adjusting for preservation time, eyes whose donors had diabetes were more than twice as likely to experience primary/early failure. 
  • Patients with PACE were more than 3 times more likely to experience late failure.

Terry M, Aldave A, Szczotka-Flynn L, et al. Donor, recipient and operative factors associated with graft success in the cornea preservation time study.  Ophthalmology. 2018;125(11):1700-1709 . doi: https://doi.org/10.1016/j.ophtha.2018.08.002

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